| Objective: To investigate the difference of clinical characteristic,cytogeneticcharacteristic and immunophenotype in children with B-ALL carrying TEL-AML1and BCR-ABL fusion gene. To study the relationship between the expression of fuiongene and prognosis.Methods: Examination of bone marrow cells was performed by short-turn culturemethod,G banding technique was used for karyotype analysis;Flow cytometry wereused to immunophenotype;RT-nested-PCR was used to detect TEL-AML1andBCR-ABL fusion genes in93children with B-ALL from hematology department ofJiangxi Children's Hospital between January2011and March2012.93patients weredivided into TEL-AML1+group,BCR-ABL+group and negative group according tothe result of fusion gene detection. The expression levels of TEL-AML1andBCR-ABL were detected in bone marrow (BM) samples obtained from patients atdiagnosis and at the end of induction of remission by RQ-PCR.Results:17TEL-AML1+and9BCR-ABL+out of93samples were dectected byRT-Nested-PCR, positive rate are18.28%and9.68%respectively. By comparison nostatistic difference was found in age, gender and complete remission rate at the end ofinduction remission among three groups. We have found significant difference amongthree groups in organ infiltrating rate,initial WBC count in peripheral blood andblasts count in bone marrow.Cytogenetic karyotype analysis was performed in93samples,no t(12;21)translocationin was observed in17TEL-AML1+patients;6out of9BCR-ABL+patients were observed Philadelphia Chromosome positive(ph+)ï¼›2patients wereobserved with t(8;14)in the negative group,no other morphological abnormalities hasbeen detected in negative group.no statistic difference was found in the hyperdiploidand hypodiploid rate among three groups.Immunophenotype assay by Flow cytometry show the rate of CommonB-ALL inthree group are76.5%,44.4%,67.2%ï¼›the rate of PreB-ALL are23.5%,33.3%,25.4%;the rate of ProB-ALL are0,22.2%,7.5%, no statistic difference was found. The positive rate of antigen such as CD10,CD19,CD20,CD22,CD34,CD38,CD79a,TdT,HLA-DR show no difference.The negative group has lower myeloidantigen expression rate compared with other two groups.The relative expression level of TEL-AML1range from2.01%to454.89%;Therelative expressionlevel of BCR-ABL range from2.94%to1208.62%.14and7samples were obtained from TEL-AML1+patients and BCR-ABL+patients at theend of induction remission respectively.5MRD positive of TEL-AML1and3MRDpositive of BCR-ABL were detected by RQ-PCR.Conclusions: TEL-AML1+patients show no significant difference withBCR-ABL+patients in the short term prognosis,but the initial tumor burden ofBCR-ABL+patients is higher than TEL-AML1+patients and fusinon gene negativepatients. RQ-PCR technology is accurate and effective in detection of the fusiongenes, the sensitivity and specificity are basically the same with NestedPCR.Application of RQ-PCR assay for quantitative detection of fusion gene,couldbetter monitoring of patients with tumor cell molecular remission and relapse status,monitoring of children with ALL short-term and long-term MRD has better clinicalapplicability. |
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