Analyzing Clonality And Clinical Significance Of B-all IgH By Gene Scanning

purpose of research：Taking advantage of Gene Scanning to analyzeclonality of newly diagnosed and complete remission after inductiontherapy B-ALL IgH and discussing clinical significance of testing B-ALLIgH clonality.Research method:Choosing bone marrow speciments of B-ALL in195cases(73cases are newly diagnosed,122cases are complete remission afterinduction therapy).All of the bone marrow are confirmed by Bone marrowmorphology and Flow cytometry.39Bone marrow of infectious diseases、Anemia diseases and healthy person as control.Extracting DNA of All thespecimens of bone marrow lymphocytes. Amplifying IgH of lymphocytes DNAby RT-PCR. Purifying products of PCR. Gene scaning products of PCR.Getting data to analyze clonality.Result:1、66pictures (90.4%)of Genescan have only one main peak in73incipient B-ALL,the rearrangement is monoclonal.5pictures(6.9%) ofGenescan have only one main peak and a little small peak,the rearrangementis oligoclonal.2pictures(2.7%) of Genescan have multi-peaks, therearrange-ment is polyclonal.By testing of X2, P<0.05， Monoclonalrearrangement is significantly higher than the oligoclonal and polyclonalrearrangement.2、26pictures (21.3%)of Genescan have only one main peak in122casesof complete remission after induction therapy B-ALL,the rearrangement ismonoclonal.2pictures(1.6%) of Genescan have only one main peak and alittle small peak,the rearrangement is oligoclonal.94pictures(77.1%)of Genescan have multi-peaks, the rearrange-ment is polyclonal. Rolyclonal rearrangement is significantly higher than the monoclonal andoligoclonal rearrangement in cases of complete remission after inductiontherapy.3、The rearrangements are rolyclonal in39infectious diseases、anemiadiseases and healthy people.4、The rearrangements is not significant correlation with risk factor、sexuality、age and white blood cell count of Newly diagnosed person.5、 Following up29monoclonal rearrangements in incipient B-ALLIgH,there are7monoclonal rearrangements in induction therapy aftercomplete remission.In monoclonal rearrangements,2cases have choosedrisking upgrade chemotherapy;1case have reappeared,it is2monthes inadvance as the clinical relapse;1case was always monoclonalrearrangements, the curative effect of chemotherapy was not good, he givedup the treatments at last.6、Following up5oligoclonal rearrangements in incipient B-ALL IgH,the curative effect of chemotherapy is good in2cases,1case arisedinfiltration of central nervous system in the15th week and giving uptreating at last,2cases are not complete remission all the time and1case choosing bone marrow transplantation、1case giving up cure.Conclusion:Genescan can analyze clonality of IgH rearrangementSimple and quick,it is high sensitivity、strong specificity、simple andintuitive in testing IgH clonality of incipient B-ALL,we can choosemonoclonal or cloning as the goal of monitoring of minimal residualdisease, it is effective way as guiding treatment、monitoring recurrenceand judgmenting prognosis.