| Objective: To investigate the clinical significance of E2A-PBX1 monitoring in the treatment of children with acute lymphoblastic leukemia(ALL)and prognosis in the initial detection of bone marrow and its application of CCLG-ALL2008 chemotherapy regimen at the 33 rd day of remission therapy.Methods: Morphology-immunology-cytogenetics-molecular studies were performed on the bone marrow of 530 children with ALL who were admitted to Shengjing Hospital of China Medical University from January 2012 to May 2017.According to the criteria of ALL risk,99 cases were divided into middle risk group,including 25 cases positive for E2A-PBX1 fusion gene as experimental group(E2A-PBX1 positive group),74 cases negative Children as control group(E2A-PBX1 negative group).The clinical manifestations and biological characteristics of the two groups were compared.Five-year event-free survival(EFS)were compared.E2A-PBX1 fusion gene was detected in 25 cases of E2A-PBX1-positive children in experiment 1 by real-time fluorescence quantitative PCR in the bone marrow of the 33 rd day after remission therapy of CCLG-ALL2008 treatment.Of these,5 were still positive(E2A-PBX1 still positive group)and 20 were negative(E2A-PBX1 negative group).The clinical manifestations and biological characteristics,five-year event-free survival(EFS)of two groups were compared.Results: There was no significant difference in five-year event-free survival,age,sex,hemoglobin,platelet and prednisone between E2A-PBX1 positive group and E2A-PBX1 negative group.(all P> 0.05).However,patients with E2A-PBX1 had high white blood cells,high-naive cells,and high LDH compared with the negative group.There was no significant difference in clinical manifestations and biological characteristics between E2A-PBX1 still positive group and E2A-PBX1 negative group.(all P> 0.05).The five-year event-free survival of E2A-PBX1 positive group and E2A-PBX1 negative group were 20.0 % and 94.7 %(P = 0.000016).We have reason to believe there is a clear difference in EFS between the two groups.So we suggest that the induction of remission on the 33 rd day of E2A-PBX1 whether negative to judge the prognosis of children with the value of the time.If it is still positive may prompt a poor prognosis,and further by PCR technology to detect E2A-PBX1 fusion gene level guide the timing of individualized bone marrow transplantation.Conclusion: So using PCR to detect E2A-PBX1 fusion gene expression level is the guide to individualized treatment,predict the recurrence of a good indicator,and induced remission of 33 days is to determine the prognosis of the key point in time. |
