儿童急性淋巴细胞白血病T细胞受体重排删除环与严重感染相关性研究

Correlation between blood T-cell receptor rearrangement excision circles levels and severe infection in children with acute lymphoblastic leukemia

摘要:

目的：定量检测急性淋巴细胞白血病（急淋）患儿不同阶段外周血中信号连接/结合T细胞受体重排删除环（sjTRECs）水平的变化，以评价其作为预测化疗后严重感染指标的可行性。方法：共收集初发急淋患儿（初发组，n=30）、早期强化化疗结束后白细胞恢复且未感染患儿（化疗组，n=36）、化疗后严重感染患儿（感染组，n=30）及正常同龄儿童（正常组，n=50）外周血标本共146份，通过FQPCR法检测其sjTRECs水平，并进行组间比较。结果：正常组平均sjTRECs为（394±270）copies/103 MNC，高于其他3组（P<0.05）；化疗组sjTRECs水平低于初发组 ［(96±78) copies/103 MNC vs (210±219）copies/103 MNC，P<0.05］；感染组sjTRECs水平最低，仅为（48±40） copies/103 MNC。结论：监测急淋患儿化疗后sjTRECs水平变化可能有助于早期预测机体严重感染的发生。

Abstract:

OBJECTIVE: This study quantitatively examined signal joint T-cell receptor rearrangement excision circles (sjTRECs) levels in peripheral blood of children with acute lymphoblastic leukemia (ALL) at different stages in order to evaluate the role of sjTRECs in predicting severe infection postchemotherapy. METHODS: sjTRECs levels in peripheral blood were measured by fluorescent quantitation-polymerase chain reaction in 30 children with newly diagnosed ALL, 36 children with ALL who accepted chemotherapy but were not infected, 30 children with ALL who had severe infection after chemotherapy, and 50 normal children. RESULTS: Blood sjTRECs levels in the normal group (394±270 copies/103 MNC) were significantly higher than those in the other three groups (P<0.05). Blood sjTRECs levels in the chemotherapy group without infection (96±78 copies/103 MNC) were significantly lower than those in the newly diagnosed ALL group (210±219 copies/103 MNC) (P<0.05). The chemotherapy group with severe infection showed the lowest blood sjTRECs levels (48±40 copies/103 MNC) in the four groups. CONCLUSIONS: The measurement of blood sjTRECs levels might be helpful for predicting the occurrence of severe infection postchemotherapy in children with ALL.