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        PCR of Gene Rearrangements for the Detection of Minimal Residual Disease in Childhood ALL

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        542
        The study of submicroscopic or minimal residual disease (MRD) in childhood acute lymphoblastic leukemia may eventually lead to stratification of therapy on an individual patient basis (reviewed in ref. 1 ). PCR of immunoglobulin heavy chain (IgH) and T-cell receptor (TCR) gene rearrangements provides widely informative markers (Table 1 ), which, in the majority of cases, are stable during the disease course (2 ). Generation of leukemia-specific probes using this technique allows detection of MRD at levels of one leukemic cell in 10,000 to 100,000 normal bone marrow mononuclear cells (BM MNC).
        Table 1  Primer Systems a

        Locus

        No b

        Primer sense (ref)

        No b

        Primer antisense (ref)

        [Mg2+ ]

        Size, bp

        +B

        +T-

        IgH FR3

        1

        5′-ACACGGC(C/T)(G/C)TGTATTACTGT-3′ (2)

        3

        5′-GTGACCAGGGT(C/T)C C(C/T)TGGCCCCAG-3′ (2)

        1.5–30

        65–155

        75%

        8%

             

        4

        5′-AACTGCAGAGGAGACGGTGACC-3′ (3)

        15–30

        80–170

           
             

        2

        5′-GACCAGGGT(C/T)C C(C/T)TGGCCCCAG-3′ e

               

        Vδ2-Dδ3

        5

        5′-CTTGCACCATCAGAGAGAGA-3′ (2)

        7

        5′-GTTTTTGTACAGGTCTCTGT-3′

        10–30

        100–150

        45%

        4%

             

        8

        5′-AGGGAAATGCACTTTTGCC-3′ (2)

        15–30

        110–170

           
             

        6

        5′-TTTTGTACAGGTCTCTGT-3′ c

               

        Vδ1-Jδ1

         

        5′-GCCTTACAGCTAGAAGATTC-3′

         

        5′-GTTCCTTTTCCAAAGATGAG-3′

        15–30

        80–150

        5%

        25%

        VγI-Jγ1/2 d

         

        5′-TG(A/C)(C/T)TCTGG(A/G)GTCTATTACTGT-3′

         

        5′-CGATACTTACCTGTGACAAC(C/A)AG-3′

        30

        80–160

        45%

        90% d

        VγII-Jγ-1/2 d

         

        5′-AAACAGGACATAGCTACCTACT-3′

         

        5′-CGATACTTACCTGTGACAAACC/AAG-3′

        30

        80–160

        45%

        90% d

        Lead Vγ2-anti Vγ2

         

        5′-GTCATGTCAGCCATTGAGTT-3′

         

        5′-TCTCTCTCTGATGGTGCAAG-3′

        15

        220

        control

        control

        a The primer shown here use a common buffer and generate products that can easily be resolved on 8% PAGE b Refers to Fig. 1 c Sequencing primers d These primers can be used in a multiplex reaction. The VγI primer is a consensus primer and amplifies all members of this group except Vγ7 + B and +T indicate the percentage of patients by lineage expected to show a clonal rearangement at each locus at diagnosis.
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