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《Journal of Applied Clinical Pediatrics》 2012-23
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Detection of Translocation ETS Leukemia-Acute Myeloid Leukemia1 Fusion Gene in Acute Lymphoblastic Leukemia Children by Real-Time Fluorescent Quantitative Polymerase Chain Reaction and Its Clinical Signi-ficance

ZHANG Rong1,LIAO Jing1,LI Ge1,SUN Huai-qiang2,SHI Yu-jun2,YANG Ji-yun3(1.Department of Pediatrics,Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital,Chengdu 610072,Sichuan Provi-nce,China;2.Laboratory of Transplant Engineering and Immunology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;3.Molecular Biological laboratory,Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital,Chengdu 610072,Sichuan Province,China)  
Objective To establish a real-time fluorescent quantitative reverse transcription-polymerase chain reaction(qRT-PCR) for detection of TEL-AML1 fusion gene mRNA in acute lymphoblastic leukemia(ALL) children and explore its clinical significance. Methods A qRT-PCR with a TaqMan fluorescence probe and 2-△△ct relative quantitative method was used to dynamically detect the expression levels of TEL-AML1 fusion gene in 20 acute lymphoblastic leukemia children with TEL-AML1 fusion gene positive at the time of newly diagnosed(n=20),complete remission(n=20),recurrence period(n=2),and 15 children with normal bone marrow morphology and with non tumor and no blood disease as a control group. Results Median of the expression level of TEL-AML1 fusion gene at newly diagnosed,complete remission,relapse period were 0.62,0.31,0.76,0.23,respectively,and there were significant differences(Pa0.05).The expression levels of TEL-AML1 gene in newly diagnosed and relapsed children were significantly higher than those of the children with remission and the control group(Pa0.05).The expression levels of TEL-AML1 gene showed no significant difference between newly diagnosed and relapsed patients(P0.05).The recurrence rate and event-free survival rate of patients with high level of TEL-AML1 expression(P75 of the control group) on day 33 were significantly higher and lower than those of low expression of children,respectively(P0.05).Twenty patients on day 33 at the end of the first induction therapy achieved completely remission by bone marrow morphological examination.After intense and maintenance therapy,the high levels of the 8 children were declined.But the level of 1 case out of 8 cases abnormally increased and then the patient relapsed during maintenance therapy.After 2 months of ending chemotherapy,another 1 patient also relapsed with high TEL-AML1 level again.The levels of minimal residual disease were positive in 8 cases by qRT-PCR test,negative in 20 cases by bone marrow morphology and karyotype analysis tests,positive in 5 cases by real-time reaverse transcription-PCR test. Conclusions qRT-PCR is a rapid,efficient,sensitive and specific method.The expression level of TEL-AML1 gene on day 33 during induction of remission can be used for early prognosis.The changes of TEL-AML1 levels can be used to monitor minimal residual disease,prediction of relapse and guide individual treatment.
【Fund】: 四川省卫生厅科研项目(070095)
【CateGory Index】: R733.7
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