Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, 060-8648, Japan.
Int J Hematol. 2010 Oct;92(3):481-9. doi: 10.1007/s12185-010-0670-1. Epub 2010 Sep 10.
Monitoring minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL) is a useful way for assessing treatment response and relapse. We studied the value of MRD and showed a correlation with relapse for 34 adult patients with ALL. MRD was evaluated by real-time quantitative polymerase chain reaction (RQ-PCR) with probes derived from fusion chimeric genes (BCR/ABL) (n = 12) or PCR-based detection of clonal immunoglobulin and T cell receptor gene rearrangements (n = 16), or both (n = 6). We analyzed 27 of the 34 patients who could be examined for MRD on day 100 after induction therapy. The overall survival (OS) rate (45.0%) and relapse-free survival (RFS) rate (40.0%) at 2 years in complete remission (CR) patients with MRD level ≥ 10⁻³ (n = 12) were significantly lower than those in CR patients with MRD level <10(-3) (n = 15) (OS rate 79.0%, RFS rate 79.4%) (log-rank test, P = 0.017 and 0.0007). We also applied multicolor flow cytometry for comparison with MRD results analyzed by PCR methods. The comparison of results obtained in 27 follow-up samples showed consistency in 17 samples (63.0%) (P = 0.057). MRD analysis on day 100 is important for treatment decision in adult ALL.
监测急性淋巴细胞白血病（ALL）患者的微小残留病（MRD）是评估治疗反应和复发的有用方法。我们研究了 34 例成人 ALL 患者的 MRD 值及其与复发的相关性。MRD 通过实时定量聚合酶链反应（RQ-PCR）与融合嵌合基因（BCR/ABL）探针（n = 12）或基于 PCR 的克隆免疫球蛋白和 T 细胞受体基因重排检测（n = 16）或两者（n = 6）进行评估。我们分析了 27 例可在诱导治疗后第 100 天检查 MRD 的 34 例患者。MRD 水平≥10⁻³（n = 12）的完全缓解（CR）患者的总生存（OS）率（45.0%）和无复发生存（RFS）率（40.0%）明显低于 MRD 水平<10(-3)（n = 15）的 CR 患者（OS 率 79.0%，RFS 率 79.4%）（对数秩检验，P = 0.017 和 0.0007）。我们还应用多色流式细胞术与通过 PCR 方法分析的 MRD 结果进行比较。在 27 个随访样本中获得的结果比较显示 17 个样本（63.0%）一致（P = 0.057）。第 100 天的 MRD 分析对成人 ALL 的治疗决策很重要。
