Liu Y-F, Zhu Y-M, Shen S-H, Shen Z-X, Li J-M, Chen S-J, Chen Z, Jiong H U
Department of Hematology, State key Laboratory for Medical Genomics, Shanghai Institute of Hematology, RuiJin Hospital, JiaoTong University School of Medicine, JiaoTong University, Shanghai, China.
Leukemia. 2006 Aug;20(8):1393-9. doi: 10.1038/sj.leu.2404262. Epub 2006 May 25.
Evaluation of molecular response is important for the diagnosis and monitoring of minimal residual disease in patients with acute promyelocytic leukemia (APL). In this study, we analyzed the molecular response by regular reverse transcription-polymerase chain reaction (RT-PCR) and quantitative real-time RT-PCR in 31 newly diagnosed patients. The real-time RT-PCR results are reported as normalized DoseN and log-reduction (3.0-4.9 log-reduction as minor and > or =5.0 log-reduction as major molecular response). After induction therapy and completion of consolidation, minor molecular response was documented in 35.5 and 96.8% patients, respectively, which was equivalent to the regular RT-PCR (22.6 and 96.8%), whereas the major molecular response rate was significantly lower (12.9 and 90.3%, respectively). All patients achieved major molecular response during and after maintenance therapy. During the follow-up study, loss of major molecular response was observed in two patients, which was associated with subsequent loss of minor molecular response, positive RT-PCR and then documentation of central nervous system leukemia or clinical relapse in 3-6 months. For summary, we demonstrated that the real-time RT-PCR is potentially superior to regular RT-PCR in evaluation of molecular response in APL patients and that reporting real-time RT-PCR data by log-reduction is feasible and clinically relevant.
评估分子反应对于急性早幼粒细胞白血病（APL）患者微小残留病的诊断和监测至关重要。在本研究中，我们通过常规逆转录聚合酶链反应（RT-PCR）和定量实时RT-PCR分析了31例新诊断患者的分子反应。实时RT-PCR结果以标准化剂量值（DoseN）和对数减少率报告（3.0 - 4.9对数减少为微小分子反应，≥5.0对数减少为主要分子反应）。诱导治疗和巩固治疗完成后，分别有35.5%和96.8%的患者记录到微小分子反应，这与常规RT-PCR结果（22.6%和96.8%）相当，而主要分子反应率显著较低（分别为12.9%和90.3%）。所有患者在维持治疗期间及之后均达到主要分子反应。在随访研究中，观察到两名患者出现主要分子反应丧失，这与随后微小分子反应丧失、RT-PCR阳性相关，随后在3 - 6个月内记录到中枢神经系统白血病或临床复发。总之，我们证明了实时RT-PCR在评估APL患者分子反应方面可能优于常规RT-PCR，并且通过对数减少率报告实时RT-PCR数据是可行的且具有临床相关性。
