Background Relapse happens frequently after allogeneic hematopoietic cell transplantation （alIo-HCT） in the patients with Philadelphia chromosome-positive acute lymphoblastic leukemia （Ph^＋ ALL）. Detection of the...Background Relapse happens frequently after allogeneic hematopoietic cell transplantation （alIo-HCT） in the patients with Philadelphia chromosome-positive acute lymphoblastic leukemia （Ph^＋ ALL）. Detection of the minimal residual disease （MRD） before and after alIo-HCT is associated with higher relapse rate. Early administration of imatinib after alIo-HCT may prevent recurrent Ph^＋ ALL. The aim of this study was to evaluate the safety and efficacy of imatinib in preventing hematological relapse when imatinib was administrated in the first 90 days after alIo-HCT. Methods Patients with Ph^＋ ALL that underwent alIo-HCT were enrolled in a prospective study. A TaqMan-based real-time quantitative polymerase chain reaction （RQ-PCR） technique was used to detect the MRD （bcr-abl transcript levels）. Imatinib therapy was initiated prior to 90 days after alIo-HCT if the patient＇s absolute neutrophil count （ANC） was above 1.0×10^9/L （without granulocyte colony-stimulating factor （G-CSF） administration） and the platelet count was greater than 50.0×10^9/L, or if the bcr-abl transcript levels were elevated in two consecutive tests, or if the bcr-abl transcript levels were 〉10.2 after the initial engraftment. The initial daily dose of imatinib was 400 mg/d for adults and 260 mg/m^2 for children （younger than 17 years）. Imatinib was administered for at least I month and the bcr-abl TaqMan results were negative for 3 consecutive tests, or complete molecular remission （CR^mol） was sustained for at least 3 months. Results From May 2005 to October 2008, 29 patients were enrolled in this study, of whom, 19 patients were male and 10 were female. The median age of the enrolled patients was 33 years （range 6-50 years）. Imatinib therapy was started at a median time of 60 days （range 20-122 days） post HCT （only one patient started Imatinib therapy at 122nd day after HCT）. Twenty-five adult patients could tolerate a dose of 300-400 mg/d of imatinib, and three children tolerated 展开更多
目的探讨 Id4基因甲基化作为检测急性白血病(AL)微量残留病变指标的可行性。方法采用甲基化特异性聚合酶链反应(MS-PCR)技术对细胞系中不同比例的白血病细胞以及正常人、初诊和完全缓解期的 AL 患者骨髓进行 Id4基因甲基化状态检测。结...目的探讨 Id4基因甲基化作为检测急性白血病(AL)微量残留病变指标的可行性。方法采用甲基化特异性聚合酶链反应(MS-PCR)技术对细胞系中不同比例的白血病细胞以及正常人、初诊和完全缓解期的 AL 患者骨髓进行 Id4基因甲基化状态检测。结果 MS-PCR 方法可在低于1%白血病细胞中检测到Id4基因甲基化。Id4基因在正常骨髓中呈完全性非甲基化状态,初治急性髓系白血病(AML)和急性淋巴细胞白血病(ALL)患者中甲基化比例分别为84%和86%。Id4基因在完全缓解的 ALL 患者中甲基化比例达60.9%,高于完全缓解状态的 AML 患者。Id4基因甲基化检测阳性的14例 ALL 患者中有8例在12个月内复发,而甲基化检测阴性的9例 ALL 患者仅有1例复发。Id4基因呈甲基化状态的8例 AML 患者中有5例在12个月内复发,而 Id4基因呈非甲基化的20例 AML患者中12个月内仅有2例复发。结论 MS-PCR 检测 Id4基因甲基化有可能作为 AL 微量残留病的检测方法。展开更多
文摘Background Relapse happens frequently after allogeneic hematopoietic cell transplantation （alIo-HCT） in the patients with Philadelphia chromosome-positive acute lymphoblastic leukemia （Ph^＋ ALL）. Detection of the minimal residual disease （MRD） before and after alIo-HCT is associated with higher relapse rate. Early administration of imatinib after alIo-HCT may prevent recurrent Ph^＋ ALL. The aim of this study was to evaluate the safety and efficacy of imatinib in preventing hematological relapse when imatinib was administrated in the first 90 days after alIo-HCT. Methods Patients with Ph^＋ ALL that underwent alIo-HCT were enrolled in a prospective study. A TaqMan-based real-time quantitative polymerase chain reaction （RQ-PCR） technique was used to detect the MRD （bcr-abl transcript levels）. Imatinib therapy was initiated prior to 90 days after alIo-HCT if the patient＇s absolute neutrophil count （ANC） was above 1.0×10^9/L （without granulocyte colony-stimulating factor （G-CSF） administration） and the platelet count was greater than 50.0×10^9/L, or if the bcr-abl transcript levels were elevated in two consecutive tests, or if the bcr-abl transcript levels were 〉10.2 after the initial engraftment. The initial daily dose of imatinib was 400 mg/d for adults and 260 mg/m^2 for children （younger than 17 years）. Imatinib was administered for at least I month and the bcr-abl TaqMan results were negative for 3 consecutive tests, or complete molecular remission （CR^mol） was sustained for at least 3 months. Results From May 2005 to October 2008, 29 patients were enrolled in this study, of whom, 19 patients were male and 10 were female. The median age of the enrolled patients was 33 years （range 6-50 years）. Imatinib therapy was started at a median time of 60 days （range 20-122 days） post HCT （only one patient started Imatinib therapy at 122nd day after HCT）. Twenty-five adult patients could tolerate a dose of 300-400 mg/d of imatinib, and three children tolerated
文摘目的探讨 Id4基因甲基化作为检测急性白血病(AL)微量残留病变指标的可行性。方法采用甲基化特异性聚合酶链反应(MS-PCR)技术对细胞系中不同比例的白血病细胞以及正常人、初诊和完全缓解期的 AL 患者骨髓进行 Id4基因甲基化状态检测。结果 MS-PCR 方法可在低于1%白血病细胞中检测到Id4基因甲基化。Id4基因在正常骨髓中呈完全性非甲基化状态,初治急性髓系白血病(AML)和急性淋巴细胞白血病(ALL)患者中甲基化比例分别为84%和86%。Id4基因在完全缓解的 ALL 患者中甲基化比例达60.9%,高于完全缓解状态的 AML 患者。Id4基因甲基化检测阳性的14例 ALL 患者中有8例在12个月内复发,而甲基化检测阴性的9例 ALL 患者仅有1例复发。Id4基因呈甲基化状态的8例 AML 患者中有5例在12个月内复发,而 Id4基因呈非甲基化的20例 AML患者中12个月内仅有2例复发。结论 MS-PCR 检测 Id4基因甲基化有可能作为 AL 微量残留病的检测方法。
