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目的：观察慢性粒细胞白血病（ＣＭＬ）异基因骨髓移植（ａｌｏ－ＢＭＴ）后残留白血病情况。方法：用逆转录－多聚酶链反应（ＲＴ－ＰＣＲ）技术测定４６例经ａｌｏ－ＢＭＴ植活的ＣＭＬ患者骨髓细胞Ｍ－ｂｃｒ／ａｂｌｍＲＮＡ表达。结果：ａｌｏ－ＢＭＴ能使约７０％ＣＭＬ患者在移植后３个月ｂｃｒ／ａｂｌｍＲＮＡ转阴。其中４例患者在移植后＋１．５～２．０个月时为ｂｃｒ／ａｂｌｍＲＮＡ（＋），于＋３个月转为阴性；１例于＋９个月转阴。１例无病存活６年以上患者，其ｂｃｒ／ａｂｌｍＲＮＡ为阳性；另１例无病存活４年以上患者ｂｃｒ／ａｂｌｍＲＮＡ为阴性。结论：ＲＴ－ＰＣＲ是当前检测残留白血病最灵敏的方法，但不能忽视其局限性。
Objective: To observe the residual leukemia after allogeneic bone marrow transplantation (alo-BMT) in patients with chronic myelogenous leukemia (CML). METHODS: M-bcr/abl mRNA expression in bone marrow cells of 46 patients with engraftment of aloe-BMT was determined by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Alo-BMT can reverse bcr/abl mRNA in approximately 70% of CML patients 3 months after transplantation. Four of these patients were bcr/abl mRNA (+) at +1.5 to 2.0 months after transplantation and became negative at +3 months. One patient had negative conversion at +9 months. One case of disease-free survival for more than 6 years was positive for bcr/abl mRNA; the other case of disease-free survival for more than 4 years was negative for bcr/abl mRNA. Conclusion: RT-PCR is currently the most sensitive method for detecting residual leukemia, but its limitations cannot be ignored.