Minimal residual leukemia in autologous peripheral blood stem cell transplantation

自体外周血干细胞移植中微小残留白血病

• 批准号: 08670902
• 负责人: IKUTA Koichiro
• 金额: $ 1.41万
• 依托单位: YOKOHAMA CITY UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08670902/
• 关键词: acute leukemia; PBSCT; PBSC; MRD; IgH; TCR; RT-PCR; chimeric RNA; 自家末梢血幹細胞移植; 微少残存白血病; 遺伝子再構成; ALL; AML

We investigated minimal residual disease (MRD) in autologous peripheral blood stem cell transplantation (PBSCT) for acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) in children. MRD can be defined as disease occurring at a subclinical level and beyond detection by conventional methods of assessment. Application of the polymerase chain reaction (PCR) to the hypervariable segment of the immunoglobulin heavy chain (IgH) gene or T-lymphocyte receptor gene and RT-PCR of specific chimera messenger RNA,allows detection of MRD in ALL and AML at a level of one leukemic cell in 10^4-10^5 normal marrow cells. The detection of MRD of harvested peripheral blood stem cell (PBSC) have a value in the indication of autologous PBSCT.We detected MRD in the harvested PBSC after complete remission for 3 cases of ALL and 4 cases of AML.In a case of AML with t(8 ; 21)(q22 ; q22), chimeric RNA was detected in PBSC.In other cases, MRD was not detected in PBSC.These 7 patients with acute leukemia were performed autologous PBSCT.Six patients have sustained complete remission without sign of MRD after transplantation. But in a case of AML with t(8 ; 21)(q22 ; q22) who has chimeric RNA in her PBSC,bone marrow relapse occurred 6 month after transplantation.

我们研究了儿童急性淋巴细胞白血病（ALL）和急性髓细胞白血病（AML）自体外周血干细胞移植（PBSCT）中的微小残留病（MRD）。MRD可定义为发生在亚临床水平且无法通过常规评估方法检测到的疾病。应用聚合酶链反应（PCR）检测免疫球蛋白重链（IgH）基因或T淋巴细胞受体基因的高变段，以及特异性嵌合体信使RNA的RT-PCR，可以在10^4-10^5个正常骨髓细胞中检测到1个白血病细胞的水平上检测到ALL和AML中的MRD。检测外周血干细胞（PBSC）的MRD对自体外周血干细胞移植（PBSCT）的适应证有一定的参考价值，我们对3例ALL和4例AML患者完全缓解后的PBSC进行了MRD检测，其中1例AML患者t（8 ; 21）（第二十二条; q22），在PBSC中检测到嵌合RNA。在其他情况下，7例急性白血病患者行自体外周血干细胞移植，6例移植后维持完全缓解，无MRD征象。1例外周血干细胞中含有嵌合体RNA的t（8 ; 21）（q22 ; q22）AML患者移植后6个月出现骨髓复发。

项目成果

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