The Clinical Study On Fused Genes Of Childhood Acute Lymphoblastic Leukemia By Multiplex RT-PCR

With the development of diagnosis and treatment in children with acute lymphoblastic leukemia(ALL), disesse free survival has been greatly improved. ALL has become a curable disease. However, leukemia is a heterogeneous disease, using the same treatment, treatment outcome is different. Part of children with strong chemotherapy and can not produce the desired therapeutic effect, and the other part of children, it does not require very strong chemotherapy. Therefore be different in children with leukemia risk assessment not only strengthen the efficacy, but will also reduce the excessively strong chemotherapy in patients with part of the second tumor and the risk of long-term decline in the quality of life.Objective To study the fusion gene derived from chromosome structural aberrations of acute lymphocyte leukemia babies,the clinical risk factor lamination and the treatment relationship between them.Methods Use multiplex nested RT-PCR method to detect the fusion gene associated with the chromosome karyotype analysis,the immunophenotype and the clinical data,the results are stable and reliable,and the results can be used to study the bone marrows samples from 38 childrenResults Among these 38 patients,14 cases(36.8%) carried with 6 kinds of fusion genes such as TEL/AML1,MLL/ENL,MLL/AF9,TLS/ERG.,BCR/ABLå’ŒCBF/MYH11. 9 ALL cases t(12;21) namely TEL/AML1 ,besides 2 cases gave up,Other 7 examples smoothly attained Complete remission (CR),now as before in CR ; 1 case t(11; 19) namely (MLL/ENL) recured (in October CR) in the treatment course, did not have alleviated after the strengthened treatment ,the family member gave up;1 case t(9; 11) namely (MLL/AF9) was not good in the induction remission response, had arrived complete remission(CR) 7 months after latter strengthened treatment; 1 case t(16; 21) namely (TLS/ERG) was not good in the induction remission response, had arrived complete remission(CR) 10 months after latter strengthened chemotherapy; 1 case high-risk (HR)ALL, t (9; 22) (q34; q11) (BCR-ABL), achieved CR after the strong chemotherapy, but reexamineed this fusion gene to show the masculine gender many times, Latter carried on the marrow to transplant; 1case CBF/MYH11 family gave up therapy.Conclusion MIC classification is one of the popular classifications in leukemia.But the genotyping has made up insufficiency in MIC classification, and can instruct lamination and the clinical care. This group prompts the TEL/AML1 expresser's chemotherapy effect to be good initially; Patients with BCR/ABL,MLL have the worst prognosis and need bone marrow transplantion or strong chemotherapy. But TLS/ERG and prognosis relations, because the clinical material are few, its prognosis also waits for the observation.Multiplex nested RT-PCR technique could quickly screen 29 kinds of fusion genes derived from chromosome structural aberrations at the same time,which may help us to improve the MICM classification,diagnose disease and assess prognosis precisely,also direct the choice of treatment and dose of chemotherapy.