Fukutani H, Naoe T, Ohno R, Yoshida H, Kiyoi H, Miyawaki S, Morishita H, Sano F, Kamibayashi H, Matsue K
Department of Internal Medicine, Nagoya University Branch Hospital, Japan.
Leukemia. 1995 Apr;9(4):588-93.
Minimal residual disease (MRD) was prospectively monitored at the 10(-5) level by the reverse transcriptase-polymerase chain reaction (RT-PCR) of PML-retinoic acid receptor alpha (RARA) transcripts from 27 acute promyelocytic leukemia (APL) patients who achieved complete remission (CR) with all-trans retinoic acid and chemotherapy (previously untreated patients, 15; refractory to chemotherapy or relapsed, 12). The RNA quality from bone marrow cells was firstly assessed by gel electrophoresis to avoid false negativity because of the fragility of the APL cells and the PML-RARA transcripts. In 12 of 15 untreated patients, RT-PCR became negative during consolidation and intensification therapy 4-16 months after the initiation of therapy, whereas it remained positive in nine of 12 refractory patients. At the end of therapy, RT-PCR was negative in 14 patients and positive in 13 patients. The former patients remained in CR at median follow-up of 9 months after the end of therapy. In the latter, however, 10 patients relapsed at a median of 5 months after the end of therapy. These results suggest that the RT-PCR assay can evaluate the quality of CR in APL and predict subsequent relapse.
通过对27例急性早幼粒细胞白血病（APL）患者的骨髓细胞进行逆转录聚合酶链反应（RT-PCR）检测早幼粒细胞白血病/维甲酸受体α（PML-RARA）转录本，前瞻性监测微小残留病（MRD）至10^(-5)水平。这些患者接受全反式维甲酸和化疗后达到完全缓解（CR）（初治患者15例；化疗难治或复发患者12例）。首先通过凝胶电泳评估骨髓细胞的RNA质量，以避免因APL细胞和PML-RARA转录本的脆弱性导致假阴性。15例初治患者中有12例在治疗开始后4-16个月的巩固和强化治疗期间RT-PCR转为阴性，而12例难治性患者中有9例仍为阳性。治疗结束时，14例患者RT-PCR为阴性，13例患者为阳性。前者在治疗结束后中位随访9个月时仍处于CR状态。然而，后者中有10例患者在治疗结束后中位5个月时复发。这些结果表明，RT-PCR检测可评估APL患者的CR质量并预测随后的复发。
