RESUMO
Objective@#To investigate the clinical significance of monitoring ETV6-RUNX1 fusion gene in children with acute lymphoblastic leukemia (ALL) after allogeneic stem cell transplantation (allo-HSCT) .@*Methods@#Clinical data of 13 children received allo-HSCT in Peking University Institute of Hematology from May 2009 to March 2016 were retrospectively collected. The ETV6-RUNX1 gene was examined by real-time quantitative polymerase chain reaction (RQ-PCR) . The correlation between its expression level and the disease status was analyzed.@*Results@#Of 13 enrolled ALL cases, the ETV6-RUNX1 expression of 7 patients converted to positive after transplant at a median time of 137 days (range, 28-270 days) . The expression level of the first positive sample was 0.034% (range, 0.004%-0.061%) . The duration from ETV6-RUNX1 positive to hematological relapse was 196 days (range, 28-666 days) . Four patients experienced relapse at a median time of 294 days (range, 104-803 days) after allo-HSCT. The ETV6-RUNX1 expression converted to positive prior to MRD. Patients with positive ETV6-RUNX1 gene expression pre-transplantation would be more likely to relapse.@*Conclusion@#Monitoring ETV6-RUNX1 by RQ-PCR could be used to evaluate MRD status after allo-HSCT. Patients with positive ETV6-RUNX1 after transplant had a poor prognosis.
RESUMO
<p><b>OBJECTIVE</b>To investigate the clinical characteristics of E2A-PBX1（immunoglobulin enhancer binding factor-pre-B leukemia）fusion gene in patients with acute lymphoblastic leukemia（ALL） after allogeneic stem cell transplantation（allo-HSCT）.</p><p><b>METHODS</b>Clinical data of 10 patients received allo- HSCT in Peking University Institute of Hematology from December 2010 to January 2015 were retrospectively collected. The E2A-PBX1 gene was examined by real-time quantitative polymerase chain reaction（RQ- PCR）. The correlation between its expression level and the disease status was analyzed.</p><p><b>RESULTS</b>Among 10 cases of enrolled ALL, the E2A-PBX1 expression of six patients converted to positive after transplant at a median time of 90 days（range, 75-180 days）. The expression level of the first positive sample was 25.200%（range, 0.022%-353.600%）. The duration from E2A-PBX1 positive to hematological relapse was 30 days（range, 0-74 days）. Finally, 4 patients underwent relapse at a median time of 164 days （range, 75- 240 days） after allo- HSCT. The expression of E2A- PBX1 and minimal residual disease （MRD）level examined by flow cytometry were positive correlated（Spearman r=0.743, P=0.002）. Once E2A-PBX1 expression converted to positive after transplant, MRD would increase rapidly. Patients with this type of ALL would have little response to the current intervention towards relapse.</p><p><b>CONCLUSION</b>Monitoring E2A-PBX1 by RQ-PCR could be used to evaluate MRD status after allo-HSCT. Patients with positive E2A-PBX1 at early stage of transplant will have a poor prognosis.</p>