新抗原基因MLAA-34在急性单核细胞白血病患者的表达及意义

摘要

目的 探讨白血病新肿瘤抗原基因MLAA-34在急性单核细胞白血病(AML-M5)初诊患者中的表达水平,分析其与临床特征及预后的关系.方法 采用基于TaqMan探针的实时荧光定量RT-PCR方法检测MLAA-34在35例AML-M5患者、40例非AML-M5急性髓细胞白血病患者、12例非白血病的血液疾病患者骨髓标本以及10例健康志愿者(正常对照)外周血单个核细胞中的表达水平并进行比较.结果 初治AML-M5患者MLAA-34 mRNA表达水平较正常对照、非AML-M5白血病及非白血病疾病患者明显增高(P＜0.05);完全缓解的M5患者MLAA-34 mRNA表达水平较治疗前明显下降(P＜0.05),复发的M5患者MLAA-34 mRNA表达水平再次增高;对8例复发的AML-M5患者进行MLAA-34基因表达水平动态监测,发现复发前MLAA-34基因表达水平有上升趋势.结论 MLAA-34基因的过表达参与了急性单核细胞白血病的发病,在AML-M5中的表达具有较高的特异性,动态监测其表达水平在AML-M5的疗效评估、预后判断及复发预测方面具有一定的临床意义.%Objective To investigate the expression levels of a novel leukemia antigen gene MLAA-34 in newly diagnosed patients with acute monocytic leukemia( AML )and its correlation with clinical features and prognosis. Method.s MLAA-34 mRNA level was detected in bone marrow samples from 35 AML-M5 patients.40 non-M5 AML patients , 12 patients with non-malignant hematologic diseases and in peripheral blood mononuclear cells( PBMCs )from 10 healthy controls by TaqMan-based real-time quantitative RT-PCR method.Results MLAA-34 mRNA expression levels were significantly higher in patients with AML-M5 than those in patients with non-M5 AML, patients with non-malignant hematologic diseases and normal controls( P ＜ 0. 05 ). MLAA-34 mRNA expression level decreased significantly in complete remission( CR )patients with AML-M5 after treatment( P ＜ 0. 05 ) . while MLAA-34 mRNA expression levels increased again in relapsed patients with AML-M5. Dynamic monitoring of MLAA-34 mRNA expression levels for eight relapsed patients with M5 showed that there was an mcreasing trend of MLAA-34 mRNA expression level before relapse. Conclusion MLAA-34 gene overexpression may involve in the pathogenesis of acute monocytic leukemia, and it has high specificity in AML-M5 patients. Dynamic monitoring of MLAA-34 expression level has a value for assessing the efficacy, predicting the relapse and the prognosis.