Rubnitz J E
Department of Hematology/Oncology, St. Jude Children's Research Hospital and University of Tennessee, College of Medicine, Memphis, TN 38105-2794, USA.
J Biol Regul Homeost Agents. 2000 Jul-Sep;14(3):182-6.
Somatically acquired genetic alterations play an important role in the pathogenesis of acute lymphoblastic leukemia. The molecular analysis of these alterations has increased our understanding of the mechanisms of leukemogenesis. In addition, this information has led to improvements in our abilities to predict treatment response and to deliver the optimal intensity of treatment to individual patients. For example, the prognosis for patients with acute lymphoblastic leukemia whose leukemic cells express the TEL-AML1 fusion is favorable when they are treated on modem chemotherapy protocols, whereas patients whose leukemic lymphoblasts contain the MLL-AF4 or the BCR-ABL fusion sometimes require allogeneic hematopoietic stem cell transplantation for cure. Molecular techniques are also used to detect minimal residual disease and genetic polymorphisms that are important in optimizing drug therapy.
体细胞获得性基因改变在急性淋巴细胞白血病的发病机制中起重要作用。对这些改变的分子分析增进了我们对白血病发生机制的理解。此外，这些信息提高了我们预测治疗反应以及为个体患者提供最佳治疗强度的能力。例如，白血病细胞表达TEL-AML1融合基因的急性淋巴细胞白血病患者，采用现代化疗方案治疗时预后良好，而白血病原始淋巴细胞含有MLL-AF4或BCR-ABL融合基因的患者有时需要进行异基因造血干细胞移植才能治愈。分子技术还用于检测微小残留病以及在优化药物治疗中很重要的基因多态性。
