唐季祿2006-07-262018-07-112006-07-262018-07-112002http://ntur.lib.ntu.edu.tw//handle/246246/23555The 8;21 translocation is one of common karyotype abnormalities in acute myeloid leukemia (AML). AML1 and ETO gene were fused in t(8;21) and can be consistently detected by RT-PCR. In this study, therapeutic monitoring of minimal residual disease (MRD) using a novel, quantitative, real-time RT-PCR was evaluated in AML with t(8;21) as a model. A t(8;21)-positive cell line, Kasumi-1, was used for constructing standard curves and the corrected AML1-ETO mRNA level relative to the expression of the GAPDH housekeeping gene was calculated. At optimal condition, this assay yield an excellent log-linear relationship of PCR threshold cycle number (CT) with wide-range of initial target mRNA concentration (correlation of coefficient, r > 0.99, n=13) and sensitivity of detecting MRD as low as 10 -5 level. Sequential measurement of AML1-ETO level was performed in 40 t(8;21)-positive patients and correlated with their clinical outcome. At diagnosis, the AML1-ETO levels ranged between 0.26~1.45-fold compared with Kasumi-1 standard. Those patients with MRD level > 10 -2 after induction therapy and/or > 10 -3 after 1-2 courses of consolidation therapy had higher risk of leukemic relapse, even treated with high-dose Ara-C or bone marrow transplant (BMT). Those patients failed to achieve MRD level < 10 -4 within 6 months after BMT eventually relapsed unless chronic graft-versus host disease occurred in time. No residual MRD (i.e. less than 10 -5 ) was detectable in 9 patients in continued remission > 2 years. These data suggest that this simple and sensitive assay is very useful in therapeutic monitoring of AML treatment, in identifying high-risk patients, and in early detection of leukemic relapse.application/pdf694747 bytesapplication/pdfzh-TW國立臺灣大學醫學院內科real-time PCRquantitationminimal residual diseaseacute myeloid leukemiareporthttp://ntur.lib.ntu.edu.tw/bitstream/246246/23555/1/902314B002244.pdf