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Objective: Acute promyelocytic leukemia (APL) is acute myeloid leukemia a type of adult acute myeloid leukemia accounted for about 10%, APL most common t (15; 17) (q22; q21) chromosomal location, The shift chromosome positive rate about 98%. The exception can involve retinoic acid receptor α (RARα), making promyelocytic leukemia PML and RARα gene rearrangement, eventually forming a characteristic sense of PML-RARα fusion gene. Use of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO, As 2 O 3 ) treatment since APL, APL complete remission rate has reached 70%. However, relapse of leukemia has been plagued late clinical remission and consolidation of maintenance therapy, the overall impact on patient survival, and relapse is mainly derived from the root of residual leukemia cells in vivo, acute leukemia minimal residual disease (MRD). Real-time PCR method can detect fusion gene product, the treatment of tumor cells in the case of abatement for monitoring MRD has great significance. This study aimed to establish real-time quantitative PCR using APL PML-RARαmRNA levels after treatment technology platform to discuss PML-RARα fusion gene and in the monitoring of MRD after remission in APL significance, as well as APL subtype relationship between prognosis. Methods: Taq Man quantitative real-time PCR method for dynamic monitoring of patients with bone marrow PML-RARα fusion gene changes. 32 patients with untreated APL patients before and after remission, consolidation and maintenance therapy tested once every three months dynamic monitoring PML-RARα fusion gene. Results: 1, the initial issuance of 32 patients 28 cases (87.5%) PML-RARα fusion gene positive, long-term follow-up of 28 cases of complete remission (CR) patients, four cases of molecular relapse occurred in one patient after 3 CR1 months after remission induction therapy of CR2, followed by three months again and hematology molecular relapse again after induction of CR3; 3 cases occurred in March and April after a recurrence of CR1, after a course of treatment after induction of remission; end of follow up survival reached 24 months. 2, this study 28 cases of APL fusion gene-positive patients in the L-type 19 cases, S-type 9 cases, by the use of ATRA or ATRA DNR after induction therapy, L-18 cases of CR, S-type with six cases of CR, two group, the difference was statistically significant (P lt; 0.05). L-1 cases relapsed, 1 died, S-type 3 cases of recurrence, 2 patients died of recurrence and mortality rates of no significant difference (P gt; 0.05). Conclusion: 1, APL in the CR of regular monitoring PML-RARα fusion gene can be found in early molecular relapse and timely treatment to avoid hematological relapse. After treatment, the PML-RARα fusion gene transcript levels were significantly decreased relapse gene transcript levels increased again, and its expression levels and clinical disease progression consistent with the therapeutic relationship, which helps to monitor MRD, evaluate the efficacy and prognosis. 2, this study found that the fusion gene-positive subtypes of APL through the same L and S CR after induction therapy are different, but the relapse rate and mortality was no significant difference.
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