IN VITRO DETECTION OF RESIDUAL LEUKEMIA

目前的光学显微镜技术无法检测到微小的 残留白血病细胞数。更敏感的技术 检测残留白血病是必要的，以便允许 更准确的缓解定义和更准确的评估 净化骨髓的有效性。最近的研究表明 大多数淋巴细胞性白血病和淋巴瘤都含有克隆性 免疫球蛋白或T细胞受体基因重排。 因此，Southern印迹分析可以检测出100个恶性细胞中的一个 正常细胞。亲和素-生物素免疫吸附可作为一种 进一步提高检测恶性细胞的能力的方法 存在于骨髓中。通过将亲和素-生物素免疫吸附结合起来 通过Southern杂交分析，有可能检测到克隆 1,000个细胞中只有一个细胞发生重排。概述的研究 在这个项目中将检测克隆基因的频率 从患者获得的骨髓中可以检测到重排 急性淋巴细胞性白血病(ALL)和淋巴瘤 用和不用亲和素-生物素的Southern杂交技术 免疫吸附。一项前瞻性研究将跟踪一组 急性淋巴细胞白血病缓解期患者是否存在 缓解期骨髓中克隆性基因重排可预测 旧病复发。类似的研究将在骨髓移植时进行。 储存并在移植时确定是否 可检测到的克隆重排的存在预示着 淋巴系统恶性肿瘤患者行AMT后复发。一次 检测的灵敏度是确定的，这些技术将 用于帮助监测清除骨髓瘤细胞的有效性 从骨髓中提取。

Current light microscopic techniques are unable to detect small numbers of residual leukemic cells. More sensitive techniques for the detection of residual leukemia are needed in order to allow a more precise definition of remission and a more accurate evaluation of the effectiveness of marrow purging. Recent work has indicated that most lymphoblastic leukemia and lymphomas contain clonal rearrangements of immunoglobulin or T-cell receptor genes. Southern blot analysis can thus detect one malignant cell in 100 normal cells. Avidin-biotin immunoadsorption can be used as a further method for enhancing the ability to detect malignant cells present in the marrow. By combining avidin-biotin immunoadsorption with Southern blot analysis, it is possible to detect clonal rearrangements in as few as one cell in 1,000. Studies outlined in this project will examine the frequency with which clonal gene rearrangements are detectable in marrows obtained from patients with acute lymphoblastic leukemia (ALL) and lymphoma by using Southern blot techniques with and without avidin-biotin immunoadsorption. A prospective study will follow a group of patients with ALL in remission to determine if the presence of clonal gene rearrangements in remission marrows is predictive of relapse. Similar studies will be carried out at the time of marrow storage and at the time of transplant to determine whether the presence of detectable clonal rearrangements is predictive of relapse after AMT for patients with lymphoid malignancies. Once the sensitivity of the assay is determined, these techniques will be used to help monitor the effectiveness of purging myeloma cells from marrow.