论文部分内容阅读
目的探讨儿童B系急性淋巴细胞白血病(B-ALL)患儿骨髓微小残留病(MRD)及检测,预测预后的可能性。方法应用四色荧光抗体标记法通过流式细胞仪检测儿童B-ALL的MRD。对41例MRD阳性患儿加强化疗强度,多次连续监测,进行追踪分析。结果41例MRD阳性患儿中复发6例,复发患儿的MRD均>0.1%,MRD出现阳性的时间均>3个月,临床分型都属高危型。MRD阳性患儿经1个疗程强烈化疗转阴27例,其中1例复发,其他均在随访中,中位随访时间24.8个月;MRD阳性2个疗程转阴14例,复发5例,缓解患儿中位随访时间22.8个月。结论MRD对B-ALL预后监测有重要意义,MRD阳性时间越长对预后越不利,加强对MRD阳性患儿的治疗对改善预后有积极作用。
Objective To investigate the possibility of detecting and predicting the prognosis of bone marrow microdissection (MRD) in children with B-cell acute lymphoblastic leukemia (B-ALL). Methods Four-color fluorescent antibody labeling method was used to detect MRD in children with B-ALL by flow cytometry. 41 cases of MRD-positive children to strengthen the intensity of chemotherapy, multiple continuous monitoring, follow-up analysis. Results Of the 41 MRD-positive children, 6 were relapsed, MRDs were> 0.1%, and MRDs were positive for> 3 months. The clinical types were all high-risk. MRD-positive children after a course of intensive chemotherapy negative 27 cases, of which 1 case of recurrence, the other were at follow-up, the median follow-up time was 24.8 months; MRD positive 2 courses overcast in 14 cases, 5 cases of recurrence, The median follow-up time was 22.8 months. Conclusion MRD is of great significance for the prognosis monitoring of B-ALL. The longer the MRD positive time is, the more adverse the prognosis is. The enhancement of MRD-positive children’s treatment has a positive effect on prognosis.