Faderl S, Estrov Z
Department of Bioimmunotherapy, University of Texas MD Anderson Cancer Center, Houston 77030, USA.
Cytokines Cell Mol Ther. 1998 Jun;4(2):73-85.
Over the last three decades, acute lymphoblastic leukemia (ALL) of childhood has turned from a once fatal condition into a disease that can be cured in about two-thirds of patients. Nevertheless, about 30% of these children relapse with a dismal prognosis. Achievement of complete remission is an essential step in successful therapy. However, patients in complete remission as defined by morphologic criteria can still harbor more than 10(9) leukemic cells. We have recently shown that residual disease is detected in most patients after completion of therapy. The amount of persistent 'indolent' disease that is actually present in a particular patient and the degree to which it must be reduced to maintain a long-term remission is largely unknown. In order to address this question, and hence to tailor efficient therapy in accordance with the needs of the individual patient, a multitude of techniques for the detection of residual disease have been developed over the last few years. The most commonly used techniques are the polymerase chain reaction (PCR) assays. These sensitive assays have revolutionized this area of research. The heterogeneity of the results obtained, however, still precludes widespread clinical applicability of these techniques.
在过去三十年中，儿童急性淋巴细胞白血病（ALL）已从一种曾经致命的疾病转变为一种约三分之二患者可治愈的疾病。然而，这些儿童中约有30%会复发，预后不佳。实现完全缓解是成功治疗的关键一步。然而，根据形态学标准定义为完全缓解的患者仍可能携带超过10⁹个白血病细胞。我们最近发现，大多数患者在治疗结束后可检测到残留疾病。特定患者实际存在的持续性“惰性”疾病数量以及为维持长期缓解必须降低的程度在很大程度上尚不清楚。为了解决这个问题，从而根据个体患者的需求定制有效的治疗方案，在过去几年中开发了多种检测残留疾病的技术。最常用的技术是聚合酶链反应（PCR）检测。这些灵敏的检测方法彻底改变了这一研究领域。然而，所获得结果的异质性仍然妨碍了这些技术在临床上的广泛应用。
