流式细胞术动态监测微小残留病在非清髓异基因造血干细胞移植治疗急性白血病患者中的意义

发布时间：2018-05-09 10:34

  本文选题：急性白血病 + 微小残留病　； 参考：《中国实验血液学杂志》2017年03期

【摘要】：目的:研究非清髓造血干细胞移植(NST)前后采用流式细胞术(FCM)动态监测微小残留病(MRD),以预测移植后急性白血病(AL)复发的意义,为临床早期干预提供指导。方法:回顾性研究2011年1月至2015年12月在军事医学科学院附属医院血液科行NST的成人AL患者51例,对所有患者移植前骨髓形态学完全缓解(CR)期内,移植前35 d内、移植后1、2、3月内,以后每3月至移植后2年、2年后每6个月内采集骨髓监测MRD。低水平MRD组(A组)共33例(移植后每次检测MRD0.2%),高水平MRD组(B组)共18例(移植后动态监测MRD,至少1次≥0.2%)。结果:移植后2组2年累计复发率分别为6.1%和50%(P=0.001)。多因素分析表明:移植后M RD≥0.2%是AL移植后复发的独立的高危因素,高水平MRD组复发风险是低水平MRD组的5.84倍(P=0.036)。移植后复发组与未复发组的死亡率分别为81.8%和46.3%(P=0.036)。结论:非清髓异基因造血干细胞移植治疗急性白血病中,采用FCM动态监测MRD是预测移植后早期复发的重要方法,移植后MRD≥0.2%可作为白血病早期复发的预警,以及指导临床早期给予干预措施的重要依据。
[Abstract]:Objective: to study the dynamic monitoring of MRDV by flow cytometry (FCM) before and after non-myeloablative hematopoietic stem cell transplantation (NST) in order to predict the recurrence of acute leukemia (ALL) after transplantation and to provide guidance for early clinical intervention. Methods: a retrospective study of 51 adult AL patients who were treated with NST from January 2011 to December 2015 in Hematology Department of affiliated Hospital of the Academy of military Medical Sciences was conducted. The bone marrow morphology of all the patients was completely relieved before transplantation and 35 days before transplantation. Bone marrow monitoring MRDs were collected within 1 ~ 2 months, 3 months, 3 months, 2 years and 2 years after transplantation. There were 33 cases in low level MRD group (MRD 0. 2% after transplantation and 18 cases in high level MRD group B) (dynamic monitoring of MRD after transplantation, 鈮，

本文编号：1865689