儿童急性淋巴细胞白血病微小残留病检测及其进展

doi:10.3969/j.issn.1673-8640.2013.04.023

摘要/Abstract

摘要： 治疗的强度应与白血病复发的风险相适应^[1-2]是当代医学对于儿童急性淋巴细胞白血病（acute lymphoblastic leukaemia, ALL）治疗的基本观念。随着多药联合强化治疗的实施，过去50年中儿童ALL的疗效得到显著提高，治愈率现已接近90%^[3]。一些学者认为以前用于评估复发风险的传统指标的指导意义已经较低。因此，寻找并在临床引入更佳预示复发的预后因子，并以此作为制定与风险相适应的治疗方案的依据成为该领域关注的热点之一。过去的20～30年中，血液病研究者致力于建立残留白血病肿瘤细胞即微小残留病（minimal residual disease, MRD）检测新方法。由于MRD检测敏感性较高，目前此指标的应用已扩展到ALL临床缓解阶段，MRD为治疗效果的评估提供了更加直接、客观的依据。目前已经完成和正在进行中的采用以MRD风险评估为基础的治疗方案的临床试验表明，以MRD为指导的治疗可能成为今后ALL的治疗标准^[4-5]。我们对ALL MRD检测方法的进展以及临床应用做一综述。

关键词: 急性淋巴细胞白血病, 微小残留病, 聚合酶链反应, 抗原受体基因, 融合基因, 流式细胞术

徐翀，何妙侠，郑建明. 儿童急性淋巴细胞白血病微小残留病检测及其进展[J]. 检验医学, 2013, 28(4): 342-347.

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