Monitoring Of Minimal Residual Disease In Patients With Acute Leukemia And Its Clinical Significance

Background: Leukemia is a kind of malignant hematopoietic stem cell cloning of disease.Depending on the degree of mature leukemia cells and the natural course of the disease,acute and chronic leukemia can be divided into two categories.Acute Leukemia(AL)cell differentiation of stagnation in the early stage,more for the primitive cells and early childish,illness development is rapid,the natural course of just a few months.Chronic Leukemia(CL)cell differentiation of stagnation in the late stage,is a more mature and immature cells and mature cells,the illness develops slowly,the natural course of several years.Acute leukemia seriously threatening the lives of patients in the short term,therefore actively explore monitoring the therapeutic effect and prognosis of acute leukemia is extremely important.complete remission of acute leukemia is that patients without disconfort,White blood cell classification of no leukemia cells;Bone marrow primitive grain type I + II(Original monocytes + childish mononuclear cells or Original lymphocytes +immature lymphocytes)5% or less,No Auer corpuscle,Normal red blood cells and megakaryocyte series,No extramedullary leukemia.Some patients still have leukemia cells under a microscope to check.We called that is minimal residual disease(minimal residual disease,MRD).MRD is the root cause of refractory acute leukemia relapse and in the future.During clinical alleviate accurate quantitative MRD is essential to the identification there is a risk of relapse of leukemia patients.More and more scholars advocate at the end of the end of induction therapy of leukemia,early strengthening late,consolidate the end,the maintenance treatment and cure stage of MRD monitoring every 3 months In the hope of earlier found leukemia relapse of leukemia and monitoring the depth of ease.Objectives: By dynamically monitoring the changes of minimal residual disease in patients with acute leukemia after complete remission,and to explore the use of minimal residual disease in clinical treatment.Methods: acute leukemia patients :49 cases of adult acute lymphoblastic leukemia with complete remission(CR)patients(male:30cases,female:19cases)and 97 cases of acute myeloid leukemia with complete remission(male:53cases,female:44cases),were observed,detected the MRDby flow cytometery,and morphology by light microscopy at the same time.The average follow-up period was 22months(3months to 42months).The average MRDlevel was got.To observe the relationship between the MRD value of different nodes and the prognosis of patients.To explore the value and guiding role of MRD in clinical treatment.Results:MRD of the 49 cases of ALLpatients :B-ALLmaximum was 7.79%,the average was0.616%,T-ALLmaximunwas1.81,the average was0.202%.MRD of 97 cases of AMLpatients : the average was0.997%,the maximum was 11.65%,the minimum was0.006%.There were 26 cases of relapsed ALLpatients and 29 cases of relapsed AMLpatients.when MRD>0.1%,the rate of relapse was significantly increased.Conclusions: Using FCM method to detect the MRD value of acute leukemia can be used as a sensitive index to evaluate the prognosis;10-4 is a significant watershed in the detection value of MRD.MRD detection value of 10-4 need to pay close attention to the risk of non remission or relapse increased。The possibility of relapse is recreased when MRD≥0.1%.when MRD≥1%,the disease might be relapsed within 3months;MRD detection by FCM is a large range(10-5-10-2).which can not be used as a single indicator of complete remission.