急性淋巴细胞白血病BCL-1重排及其临床意义。

X Liu, Z Tang
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摘要

探讨急性淋巴细胞白血病BCL-1重排(BCL-1/IgH基因重排)及其临床意义。采用半巢式聚合酶链式反应(PCR)技术扩增38例急性淋巴细胞白血病(ALL)患者外周血和骨髓单个核细胞的基因组DNA,免疫组织化学法检测单个核细胞cyclin D1蛋白的表达。急性粒细胞白血病10例,慢性粒细胞白血病2例,正常骨髓10例作为对照组。结果显示,38例ALL患者中3例(7.9%)检测到BCL-1重排,4例(10.5%)检测到cyclin D1蛋白阳性表达。3例ALL BCL-1重排患者均为b细胞白血病(B-ALL),并伴有cyclin D1蛋白表达。12例粒细胞白血病患者和10例正常骨髓均未检测到BCL-1/IgH重排和cyclin D1蛋白表达。BCL-1重排及(或)cyclin D1蛋白表达的B-ALL患者外周血白细胞计数明显升高,化疗反应不良。结论:1)急性B淋巴细胞白血病中存在BCL-1/IgH基因重排;2) BCL-1重排和(或)cyclin D1蛋白表达的B-ALL患者预后较差。
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BCL-1 rearrangement in acute lymphocytic leukemia and its clinical significance.

BCL-1 rearrangement (BCL-1/IgH gene rearrangement) in acute lymphocytic leukemia and its clinical significance was investigated. In 38 patients with acute lymphocytic leukemia (ALL), the genomic DNA of mononuclear cells isolated from peripheral blood and bone marrow was amplified by using hemi-nested polymerase chain reaction (PCR) technique and the expression of cyclin D1 protein of mononuclear cells was detected by using immunohistochemical method. Ten patients with acute granulocytic leukemia, 2 with chronic granulocytic leukemia and 10 with normal bone marrow served as control group. The results showed that BCL-1 rearrangement was detectable in 3 of 38 ALL patients (7.9%) and cyclin D1 protein positive expression was detected in 4 ALL patients (10.5%). Three ALL patients with BCL-1 rearrangement were all B-cell leukemia (B-ALL) and accompanied by cyclin D1 protein expression. No BCL-1/IgH rearrangement or cyclin D1 protein expression was detected in 12 patients with granulocytic leukemia and 10 cases of normal bone marrow. Leukocyte counts in peripheral blood of B-ALL patients with BCL-1 rearrangement and (or) cyclin D1 protein expression were significantly increased and the patients had bad reaction to chemotherapy. It was concluded that: 1) BCL-1/IgH gene rearrangement were detected in acute B lymphocytic leukemia; 2) B-ALL patients with BCL-1 rearrangement and (or) cyclin D1 protein expression had poor prognosis.

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