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目的 探讨以恶性血液肿瘤患儿骨髓微量残留病检测预测预后的可能性。方法 选择75例完全缓解期急性淋巴细胞白血病或Ⅳ期非霍奇金淋巴瘤或Ⅳ期神经母细胞瘤患儿 ,骨髓及临床持续缓解 3个月以上。神经母细胞瘤患儿采用反向聚合酶链反应 (PCR)测定骨髓微量残留病 ;其余患者以IgH及TCRγ基因重排为标志 ,用PCR测定骨髓微量残留病。结果 35例患者骨髓微量残留病阳性 ,随诊结果 2 1例于测定后 3～ 40个月复发 (6 0 % ) ;阴性 40例 ,7例复发 (17% ,χ2 =12 .5 9,P <0 .0 1)。结论 提示部分恶性血液肿瘤患儿用PCR检测骨髓微量残留病可预测临床预后。
Objective To investigate the possibility of predicting the prognosis of bone marrow micrometastasis in children with hematologic malignancies. Methods 75 children with complete remission acute lymphoblastic leukemia or Ⅳ non-Hodgkin’s lymphoma or Ⅳ neuroblastoma were selected. The bone marrow and clinical remission were maintained for more than 3 months. In children with neuroblastoma, bone marrow micro-residual disease was detected by reverse polymerase chain reaction (PCR). The remaining patients were identified by IgH and TCRγ gene rearrangements, and bone marrow micro-residual disease was detected by PCR. Results Thirty-five patients had positive bone marrow remnants disease, 21 cases were followed up 3 to 40 months after the test (60%), 40 cases were negative, and 7 cases relapsed (17%, P = 12.59, P <0 .0 1). Conclusion The results suggest that some children with malignant hematological malignancy can predict the clinical prognosis of bone marrow microdialysis by PCR.