摘要
目的 研究慢性髓系白血病 (CML)bcr abl融合基因转录子类型与临床的关系。方法 采用RT PCR技术检测 5 37例临床怀疑CML的患者新鲜骨髓标本三种bcr abl(M、m及 μ型 )融合基因的表达。结果 4 79例CML患者M bcr abl阳性 ,其中慢性期 (CP) 370例 ,加速 急变期 (AP BC) 10 9例 ,CP期和AP BC期患者表达b2a2型融合基因转录子的百分率分别为 32 .4 % (370例中 12 0例 )及 36 7%(10 9例中 4 0例 ) (P >0 .0 5 ) ,急淋变及急髓变患者b2a2型百分率分别为 5 2 .6 % (19例中 10例 )及33 3% (90例中 30例 ) (P >0 .0 5 ) ;b3a2型患者初诊时外周血血小板数明显高于b2a2型患者 [(4 85 .9±333.8)× 10 9 L]vs [(380 .5± 32 1.9)ⅹ 10 9 L](P <0 .0 5 ) ;6 6 .0 %CP及 6 4 .4 %AP BC患者同时表达M bcr abl及m bcr abl;1例单纯m bcr abl(+)患者表现为急性髓系白血病 (AML) ;2例 μ bcr abl(+)患者均具有典型CML表现。结论 典型CML患者几乎均为M bcr abl融合基因阳性 ,大部分患者同时伴有m bcr abl表达 ,个别CML患者可以为 μ型 ;除了急性淋巴细胞白血病 (ALL)外 ,单纯m bcr abl(+)也可见于AML或CML急粒变的患者 ;b3a2型患者初诊时更易有血小板数增高表现。
Objective To investigate the relationship between three types of bcr/abl fusion transcripts and clinical manifestation in chronic myeloid leukemia (CML). Method M , m and μ bcr/abl fusion transcripts were detected by reverse transcriptase polymerase chain reaction(RT PCR) technique in 537 fresh bone marrow samples of patients suspected CML clinically. Results Of 573 patients, 479 expressed M bcr/abl transcripts, among whom 370 were in chronic phase(CP), and 109 in accelerated (AP)/blastic phase (BP). The percentages of patients with b2a2 transcripts in CP and AP/BP were 32.4% (120/370) and 36.7%(40/109)(P>0.05). The b2a2 transcript patients in blastic crisis were 52.6%(10/19) for lymphoblastic and 33.3% (30/90) for myeloblastic (P>0.05).The platelet count of untreated patients with b3a2 isoform [(485.9±333.8)ⅹ10 9/L,n=125] was distinctly higher than those with b2a2 isoform [(380.5±321.9)ⅹ10 9/L, n=62] (P<0.05). 66.0%(31/47) and 64.4%(29/45) of the patients in CP and AP/BP respectively co expressed M and m bcr/abl transcripts (P>0 05). One patient expressed only m bcr/abl transcript was of typical acute myeloblastic leukemia (AML). Both two μ bcr/abl(+) patients were of typical CML. Conclusions Almost all typical CML patients express M bcr/abl transcripts, most of them coexpress M bcr/abl and m bcr/abl transcripts,a few possesses only μ bcr/abl fusion gene. m bcr/abl(+) are usually associated with AML or CML in myeloblastic crisis besides acute lymphoblastic leukemia(ALL). Patients with b3a2 isoform are prone to higher platelet count before treatment.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2003年第7期347-350,共4页
Chinese Journal of Hematology
