摘要
目的分析儿童急性T淋巴细胞白血病微小残留病检测的临床价值。方法选取2010年11月~2012年1月在我院接受治疗的急性T淋巴细胞白血病患儿72例作为研究对象,在患儿治疗的不同时间点,对其实施多参数流式细胞术跟踪监测,对不同微小残留病水平患儿的临床特征和预后进行观察、分析。结果在对72例患儿进行随访1个月~7年,其中存活51例(70.83%)、发生事件20例(27.78%)、死亡1例(1.38%),死亡患儿是由于在诱导治疗期间骨髓抑制感染性休克所导致;疾病复发15例(20.83%);随着对患儿的治疗,在最终存活的51例患儿中,通过对其监测,发现其微小残留病水平一直低于检测下限,且无事件发生。随着疾病治疗的持续,患儿微小残留病阳性率逐渐升高;患儿微小残留病水平中位数呈先降低后升高的现象;其中强化治疗前微小残留病阳性例数明显高于诱导治疗33 d、巩固治疗前和再诱导治疗前,微小残留病水平中位数明显高于诱导治疗33 d、巩固治疗前,而微小残留病中位数明显低于诱导治疗33 d、巩固治疗前,差异有统计学意义(P<0.05)。在完全缓解的62例患儿中,有6例患儿的水平≥10-2,5例复发、1例死于感染;有12例患儿的水平在(1~10)10-3之间,5例复发、且1例患儿由于并发症而出现死亡;微小残留病水平在(1~10)10-4之间的患儿23例,有1例患儿出现病情复发现象。部分缓解患儿共5例,但有2例出现病情复发;在5例未缓解的患儿中,均诱导失败。微小残留病水平<10-4组和微小残留病水平10-4~10-3组完全缓解例数明显高于微小残留病水平≥10-2组和微小残留病水平10-3~10-2组,差异有统计学意义(P<0.05)。结论对急性T淋巴细胞白血病患儿进行微小残留病水平检测,可以评估患儿的早期治疗情况,对调整治疗策略、病情预后评估具有重要作用。
Objective To analyze the clinical value of the detection of minimal residual disease in children with acute T lymphocytic leukemia. Methods A total of 72 children with acute T lymphocytic leukemia treated in our hospital from November 2010 to January 2012 were enrolled. Multi-parameter flow cytometry was performed at different time points of treatment. The clinical features and prognosis of the children with different minimal residual disease levels were observed and analyzed. Results The 72 patients were followed up for 1 month to 7 years, of which there were 51 survived patients(70.83%), 20 patients with incident(27.78%), and one death(1.38%) caused by myelosuppression septic shock during induction therapy, and 15 patients with recurrence(20.83%). With the continuous treatment and monitoring, of the 51 survived patients, it was found that the levels of minimal residual disease were lower than the lower limit of detection and there was no incident. With the continuous treatment, the positive rate of minimal residual disease in children was increased gradually, and the median number of minimal residual disease in children was first decreased and then increased. The number of positive cases of minimal residual disease before intensive treatment was significantly higher than that after 33 days of induction treatment, before consolidation treatment and before re-induction treatment,and the median of minimal residual disease was significantly higher than that after 33 days of induction treatment and before consolidation treatment, with statistically significant differences(P<0.05). Of the 62 patients with complete remission, there were 6 patients with levels ≥10-2, including 5 patients with recurrence and one death due to infection, 12 patients with levels between(1-10)10-3, including 5 patients with recurrence and one death due to complications, and 23 patients with levels between(1-10) 10-4, including 1 patient with recurrence. There were 5 patients with partial remission, including 2 patients with recurrence. Of
作者
谭珊
任建敏
史杨
TAN Shan;REN Jianmin;SHI Yang(Department of Clinical Laboratory,Lishui Central Hospital in Zhejiang Province,Lishui323000,China)
出处
《中国现代医生》
2019年第32期115-118,122,共5页
China Modern Doctor
基金
浙江省自然科学基金青年基金项目（LQ17H080001）
关键词
急性T淋巴细胞
白血病
微小残留病
检测
预后
Acute T lymphocytes
Leukemia
Minimal residual disease
Detection
Prognosis
