PCR amplification was used to detect immunoglobulin heavy chain (IgH), T-cell receptor (TCR)Vγ1-Jγ, Vδ2-Dδ 3 rearranged genes in 45 cases of acute lymphoblastic leukemia (ALL) and IgH gene rearrangement in 41 cases acute nonlymphoblastic leukemia (ANLL). The positive percentage of the IgH, TCR Vγ1-Jγ and Vδ 2-Dδ3 gene rearrangement was found to be 66. 7%, 62.2%, and 35. 6%, respectively in 45 ALL patients. Multiple rearranged IgH gene bands were found in 8 (26. 7% ) out of 30 ALL patients with IgH gene rearrangement. IgH gene rearrangemens were found in 7 (17. 1% ) out of 41 ANLL patients. ALL patients with positive IgH rearranged gene were with B cell and those with positive TCR Vγ1-Jγ gene rearrangements and with negative IgH rearranged gene were with T-ALL,those with positive both IgH and TCR Vδ2-Dδ3 rearranged genes mostly were with preB-ALL. The complete remission (CR) rate was low in ALL patients with multiple rearranged heavy chains and ANLL patients with IgH gene rearrangement, who were more likely to have a clinical relapse, which may be due to clonal evolution. In complete remission (CR) patients, the cytologic relapse fell behind postive PCR results for an average periods of 7. 2 weeks (range 2 to 23 weeks). Using PCR to detect rearranged genes could be helpful in determining the efficacy of chemotherapy, predicting clinical relapse, assisting gene typing and predicting prognosis.
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