摘要
背景与目的:Epstein-Barr病毒(EBV)与多种肿瘤的发生密切相关,为此我们探讨在儿童白血病中EBV的感染及其临床意义。方法:采用荧光定量聚合酶链反应(fluorescencequantitative-polymerasechainreaction,FQ-PCR)技术,检测35例儿童白血病[其中急性淋巴细胞白血病(acutelymphoblasticleukemia,ALL)26例(初治24例,复治2例);急性非淋巴细胞性白血病(acutenonlymphocyticleukemia,ANLL)8例;慢性淋巴细胞性白血病(chroniclymphocyticleukemia,CLL)1例]及14例正常儿童外周血单核细胞EBV-DNA的含量,并结合患儿的临床表现、泼尼松敏感试验、诱导治疗完全缓解率,分析在儿童白血病患者血中EBV的感染及其临床意义。结果:35例儿童白血病患儿中8例(22.86%)有EBV感染。其中26例ALL中7例(26.92%)EBV感染,EBV-DNA含量为(5.14±6.91)×105copy/ml;8例ANLL中1例(12.5%)EBV感染,EBV-DNA含量为4.031×103copy/ml;1例CLL及14例正常对照儿童未检测到EBV-DNA的含量。EBV感染的儿童白血病患儿白细胞数[(144.64±46.41)×109/L]和肝脾肋下≥5cm发生率87.5%均高于非EBV感染患儿[(31.04±60.27)×109/L和7.4%,P<0.001]。感染EBV和非EBV感染的ALL患儿泼尼松疗效者分别为100%、26.32%(P=0.001);诱导治疗完全缓解率分别为28.57%、84.21%(P=0.003)。ANLL患儿中,1例感染EBV者的诱导治疗完全缓解率(100%)和早期复发率(100%)较未感染EBV的7例(84.21%,28.57%)高,二者无显著性差异(P>0.05)。结论:EBV感染组儿童白血病患儿肝脾肿大明显,外周血白细胞数明显高于非EBV感染者,EBV感染ALL组对泼尼松敏感试验反应差,诱导治疗获得完全缓解率低。
BACKGROUND ＆ OBJECTIVE： Epstein-Barr virus （EBV）is associated with genesis of many human tumors. This study was to detect EBV infection in pediatric leukemia, and to explore its clinical significance. METHODS：EBV DNA in peripheral blood mononuclear cells in 35 pediatric leukemia patients, including 26 cases of acute lymphoblastic leukemia （ALL） （24 received initial treatment and 2 received retreatment）, 8 cases of acute non-lymphocytic leukemia （ANLL） and 1 case of chronic lymphocytic leukemia （CLL）, and in 14 healthy children was detected by fluorescent quantitative polymerase chain reaction （FQ-PCR）. Its clinical significance was analyzed according to the clinical manifestations, prednisone sensitivity test, and complete remission （CR） rate after induction chemotherapy. RESULTS： EBV DNA was detected in 8 （22.86%） of the 35 pediatric leukemia patients. The positive rate of EBV DNA was 26.92% （7/26） in ALL with quantity of （5.144±6.91）×10^5 copies/ml, and 12.5% （1/8） in ANLL patients with quantity of 4.031×10^3 copies/ml. No EBV DNA was detected in CLL patients and healthy controls. The occurrence rates of peripheral leukocytosis and hepatosplenomegaly were significantly higher in the patients with EBV infection than in the patients without EBV infection （P 〈0.001）. In ALL, the rate of no response to prednisone was significantly higher in the patients with EBV infection than in the patients without EBV infection （100% vs. 26.32%, P =0.001）; CR rate after induction chemotherapy was significantly lower in the patients with EBV infection than in the patients without EBV infection （28.57% vs. 84.21%, P=0.003）. In ANLL, the differences of CR rate and relapse rate were not significant between the patients with and without EBV infection （P= 0.5）. CONCLUSIONS： Pediatric leukemia patients with EBV infection have higher incidence of peripheral leukocytosis and hepatosplenomegaly. ALL patients with EBV infection have poor prednisone response and low CR rate.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2007年第1期54-57,共4页
Chinese Journal of Cancer
