Objective To monitor the expression patterns of bcr-abl in chronic myeloid leukemia (CML) patients during treatment with imatinib mesylate and evaluate the detection of MRD by RQ-PCR method. Methods The ABI Prism 7500 Sequence Detection System using Taqman fluorogenic probes was used to quantify target gene. bcr-abl mRNA was detected by RQ-PCR in 106 CML patients. The normalized quotient (NQ) of bcr-abl mRNA was calculated as followings: NQ=bcr-abl mRNA copy numbers/abl mRNA copy numbers. Results The NQ of BCR-ABL mRNA was well correlated with the progression of disease and the number of Ph+ cell (r =0.9824 and 0.9346, respectively). The NQ was decreased rapidly in 62 patients and kept in low level for a long time, and only 2 of them were relapsed. For 8 patients, after treatment the NQwere decreased initially and increased sharply, 7 of them were relapsed after 5-9 months. After treatment the NQ of 31 patients were still>0.1, 11 patients were relapsed after a short remission and 7 were ineffective or progression. Out of 5 patients whose NQ were fluctuated and had little regularity, but all of them had a continuing remission. Conclusion RQ-PCR is a more sensitive technique in the detection of bcr-abl fusion gene.It is an important method to monitor the tumor cell during the treatment with imatinib mesylate in CML patients.%目的 应用实时定量聚合酶链反应(RQ-PCR)技术动态监测接受伊马替尼(IM)治疗的慢性粒细胞白血病(CML)患者bcr-abl融合基因拷贝数的变化,探讨RQ-PCR技术在微小残留病(MRD)检测以及预测复发方面的应用.方法 应用RQ-PCR技术动态监测106例接受IM治疗的CML患者bcr-abl融合基因拷贝数,bcr-abl融合基因定量结果以校正比值(NQ)表示,NQ=bcr-abl拷贝数/abl拷贝数.结果 IM治疗前患者的NQ值与其疾病进展及Ph+细胞数量均显著相关(r=0.9824,r=0.9346).使用IM治疗的106例患者,62例在治疗12个月内NQ值迅速下降并长时间维持在较低水平,其中仅2例复发;8例在治疗后NQ值略有下降但随后又马上升高,其中7例在NQ值升高后的5~9个月内复发;31例治疗后NQ值未见明显下降且仍>0.1,其中11例获得过短暂的形态学缓解,随后迅速复发,7例治疗无效或疾病进展;另有5例虽然NQ值波动较大,且无规律性,但治疗后一直处于形态学缓解.结论 RQ-PCR方法准确、可靠、敏感度高,在监测CML患者的MRD、判断疗效以及预测复发等方面具有重要的临床应用价值.
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