A Comparative Study On The Diagnoostic Value And Prognostic Significance Of Cytogenetics And RT-PCR In Bcr/abl-Positive Acute Iymphoblastic Leukemia In Adults

Objective: To compare cytogenetic analysis and PCR method in diagnosis and remission of acute lymphoblastic leukemia in adults and define their clinical value.Methods: Bone marrow or peripheral blood samples from 31 adult ALL patients (27 de novo ALL patients and 4 CML-BP patients) were analyzed by cytogenetic RHG banding technique and nested-RT-PCR method synchronously. Nineteen patients who received chemotherapy reached complete remission and were followed up. And the sensitivity of detecting MRD through nested-RT-PCR was carried out.Results: l.de novo ALL patients' results: In 27 patients whose samples were used to detect Ph chromosome by cytogenetic analysis, 8 were positive. Among those patients whose samples were used to detect bcr/abl rnRNA, 11 cases were positive. Eight expressed both Ph and bcr/abl , sixteen expressed neither Ph nor bcr/abl. (2) CML-BP patients' results: In 4 patients whose samples were used to detect both Ph chromosome and bcr/abl rnRNA, all werepositive. 2. The results of patients in remission: bcr/abl mRNA was detected in 19 patients who were in remission, and 4 cases with positive results relapsed within 1-13 months. Among the remaining 15 cases were negative and 5 patients relapsed, the others were still in completely remission.Conclusions: 1. Each method, cytogenetic analysis or PCR had its advantages and shortcomings. The better method is integration of two methods in diagnosis, which provides reliable information for clinic. 2. The patients in CR with MRD, should be given consolidate treatment and monitoring. Nested-RT-PCR was highly sensitive, and more suitable than cytogenetic analysis in remission, which is of importance to clinic.