分子生物学的手法を用いた小児急性リンパ性白血病の微小残存病変(MRD)量迅速測定法の治療への応用

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Background : Response to initial treatments is related with prognoses of childhood acute lymphoblastic leukemia (ALL). Recently, minimal residual disease (MRD) measured by polymerase chain reaction (PCR) has been utilized to evaluate the response to initial treatment in these patients. Aim : To test the hypothesis that the determination of MRD measured by PCR method can be obtained within a short period (<14 days) and thus can be used to determine treatment protocols after initial therapy of childhood ALL. Method : All patients with childhood ALL registered in ALL2004-MRD Pilot protocol of Children Cancer and Leukemia Study Group (CCLSG) were enrolled. DNA of leukemic cells was extracted from patients' bone marrow. TCR/Ig gene rearrangements were screened, and monoclonal gene rearrangements were confirmed. The sequences of the rearranged monoclonal genes were analyzed and the allele-specific oligonucleotide (ASO) primers were made. MRD was determined with nested-PCR for each rearranged primer and subsequently for each ASO primer using the bone marrow specimens after the initial treatments. Results : The MRD measurement could be obtained from 92% of the specimens. The average period from specimen collection to the report of the results was 6.2 days. In one case, we could not report the MRD result within 14 days, but it did not affect the treatment protocol. Conclusion : The present study shows that the results of MRD with the PCR methods can be obtained within 14 days and therefore this method can be applied to tailoring treatment protocol after initial therapy for childhood ALL.
愛知医科大学の論文
2006-12-15

分子生物学的手法を用いた小児急性リンパ性白血病の微小残存病変(MRD)量迅速測定法の治療への応用

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