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[运用高灵敏度数字PCR成功检测华氏巨球蛋白血症合并骨髓纤维化中的MYD88 L265P突变]

[Successful detection of MYD88 L265P mutation in Waldenström's macroglobulinemia complicated with myelofibrosis using highly sensitive digital PCR].

作者信息

Nawata Ryohei, Sugiyama Akiko, Harada Keisuke, Shinohara Kenji, Yujiri Toshiaki

机构信息

Department of Hematology, Japan Community Healthcare Organization (JCHO) Shimonoseki Medical Center.

Department of Medicine, Towa Municipal Hospital.

出版信息

Rinsho Ketsueki. 2019;60(8):903-909. doi: 10.11406/rinketsu.60.903.

Abstract

A 78-year-old man with anemia (Hb 9.6 g/dl) and elevated serum immunoglobulin M (IgM 3,577 mg/dl) levels was referred to our hospital. Bone marrow aspiration yielded a dry tap, and bone marrow biopsy revealed the infiltration of CD20 positive lymphoplasmacytic lymphoma cells and myelofibrosis. The patient was diagnosed with Waldenström's macroglobulinemia complicated with myelofibrosis. TGF-β plasma concentration was elevated. Further, after chemotherapy with bendamustine and rituximab, remission of both Waldenström's macroglobulinemia and myelofibrosis was achieved, and TGF-β levels normalized. MYD88 L265P mutation was detected using highly sensitive digital PCR, which compared with currently used direct PCR product sequencing, has a superior sensitivity. The use of digital PCR has additional advantages toward MYD88 L265P detection, particularly when the available amount of sample DNA is limited owing to myelofibrosis.

摘要

一名78岁男性,伴有贫血(血红蛋白9.6 g/dl)和血清免疫球蛋白M水平升高(IgM 3577 mg/dl),被转诊至我院。骨髓穿刺呈干抽,骨髓活检显示CD20阳性淋巴浆细胞淋巴瘤细胞浸润及骨髓纤维化。该患者被诊断为华氏巨球蛋白血症合并骨髓纤维化。转化生长因子-β(TGF-β)血浆浓度升高。此外,在接受苯达莫司汀和利妥昔单抗化疗后,华氏巨球蛋白血症和骨髓纤维化均获缓解,TGF-β水平恢复正常。使用高灵敏度数字PCR检测到MYD88 L265P突变,与目前使用的直接PCR产物测序相比,其灵敏度更高。数字PCR在检测MYD88 L265P方面具有额外优势,尤其是当由于骨髓纤维化导致样本DNA可用量有限时。

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