Bernell P, Arvidsson I, Jacobsson B, Hast R
Department of Medicine, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Br J Haematol. 1996 Dec;95(4):666-72. doi: 10.1046/j.1365-2141.1996.d01-1945.x.
Fluorescence in situ hybridization in combination with morphology (MGG/FISH) was used to detect minimal residual disease (MRD) in complete remission (CR) in 12 cases of acute leukaemia (six MDS-AML, five de novo AML, one pre-B ALL) with numerical chromosomal aberrations at diagnosis. Residual leukaemic cells could be detected in the remission bone marrows by MGG/FISH in five patients, whereas the other seven showed no abnormalities. All five patients with signs of MRD at CR relapsed in the bone marrow with 2-9 months, in contrast to two of seven with a normal finding by MGG/FISH at CR. In both these patients a second MGG/FISH analysis showed that a subpopulation of leukaemic blasts had reappeared, 4 and 5 months prior to the leukaemia becoming clinically overt. One patient suffered a CNS relapse, but without any evidence of bone marrow involvement. The remaining four patients with no evidence of MRD at CR were still in haematological remission at follow-up after 4, 11, 12 and 13 months, respectively. We conclude that MGG/FISH seems to be a clinically useful method to detect MRD in acute leukaemia and to predict relapses, particularly when repeat studies are performed during CR.
采用荧光原位杂交结合形态学方法（MGG/FISH）检测12例急性白血病（6例骨髓增生异常综合征相关急性髓系白血病、5例原发性急性髓系白血病、1例前B淋巴细胞白血病）患者完全缓解（CR）期的微小残留病（MRD），这些患者在诊断时存在染色体数目异常。通过MGG/FISH在5例患者的缓解期骨髓中检测到残留白血病细胞，而其他7例未显示异常。所有5例CR期有MRD迹象的患者在2 - 9个月内骨髓复发，相比之下，7例CR期MGG/FISH检查结果正常的患者中有2例复发。在这2例患者中，第二次MGG/FISH分析显示，在白血病临床明显发作前4个月和5个月，白血病原始细胞亚群再次出现。1例患者发生中枢神经系统复发，但无骨髓受累证据。其余4例CR期无MRD证据的患者在分别随访4、11、12和13个月后仍处于血液学缓解状态。我们得出结论，MGG/FISH似乎是一种临床上有用的检测急性白血病MRD并预测复发的方法，尤其是在CR期进行重复检查时。
