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首页> 外文期刊>Hematology, Transfusion and Cell Therapy >Qualitative polymerase chain reaction versus quantitative polymerase chain reaction for the detection of minimal residual disease in children with acute lymphoblastic leukemia
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Qualitative polymerase chain reaction versus quantitative polymerase chain reaction for the detection of minimal residual disease in children with acute lymphoblastic leukemia

机译：定性聚合酶链反应与定量聚合酶链反应用于检测急性淋巴细胞白血病儿童的最小残留病

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In acute lymphoblastic leukemia (ALL), remission is classically defined as the reestablishment of normal hematopoiesis and the presence of less than 5% of the nucleated blast cell population found by conventional microscopy; this is used in older protocols to assess treatment response. Morphological analysis, although useful and applicable at any center, has proven to be of limited sensitivity, subjective and imprecise to study early response to treatment and this technique does not appear to be sufficient to identify patients at true risk of relapse who might benefit from the intensification of treatment.1, 2 For this reason, cytomorphological analysis has been replaced by minimal residual disease (MRD) monitoring in several treatment protocols and new definitions of remission and relapse in childhood ALL have been proposed.3The analysis of MRD has proved to be the strongest independent prognostic factor in all studies analyzing large series of patients with B-lineage and T-cell ALL, and specific molecular subgroups such as patients with the BCR-ABL fusion gene and ALL patients with MLL gene rearrangements. This analysis allows more accurate risk group assignment and tailoring the intensity of treatment, permitting reduction or intensification at the different treatment time points according to the MRD level.4, 5, 6, 7, 8, 9 MRD monitoring can also guide treatment decisions in relapsed patients and those who are candidates for bone marrow transplantation.4, 5, 10, 11.
机译：在急性淋巴细胞性白血病（ALL）中，缓解的经典定义是正常造血功能的恢复和常规显微镜下发现的少于5％的有核胚细胞总数。在较旧的方案中使用它来评估治疗反应。形态学分析尽管在任何中心都有用且适用，但已证明其敏感性有限，对治疗的早期反应进行研究的主观且不够精确，并且该技术似乎不足以识别可能从中受益的真正复发风险的患者。 1,2因此，在几种治疗方案中，细胞形态学分析已被最小残留疾病（MRD）监测所取代，并提出了儿童ALL缓解和复发的新定义。3事实证明，MRD的分析是在所有分析B谱系和T细胞ALL的大系列患者以及特定分子亚组（例如具有BCR-ABL融合基因的患者和具有MLL基因重排的ALL患者）的所有研究中，最强的独立预后因素。这种分析可以更准确地确定风险组并调整治疗强度，从而根据MRD水平在不同的治疗时间点减少或加强治疗。4、5、6、7、8、9 MRD监测还可以指导治疗决策。复发的患者以及那些适合骨髓移植的患者。4，5，10，11。

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