Abstract | BACKGROUND AND OBJECTIVE: DESIGN AND METHODS: A total of 402 bone marrow samples from 40 patients transplanted in chronic phase (group 1) and 15 in accelerated/blastic phase (group 2) were analyzed by qualitative and quantitative PCR. RESULTS: Regarding clinical outcome, 34/40 (85%) group 1 vs. 8/15 (54%) group 2 patients are alive. Only 1/40 (2.5%) group 1 patient relapsed, as against 6/15 (40%) in group 2 (p = 0. 0002). At qualitative PCR, 8/40 (19%) group 1 vs. 9/15 (60%) group 2 patients were positive, with a significantly greater total number of positive samples in group 2 (33/129, 27% vs. 16/273, 5%; p<0.001). The probability of qualitative PCR positivity >1 year after BMT was significantly lower in group 1 patients (4/40 pts, 10% vs. 9/15 pts, 60%; p = 0.01). At quantitative PCR, 4/8 (50%) group 1 patients were positive only once (< 400 transcripts/microg RNA). In group 2, 9/15 (60%) patients had 3 or more positive samples (always with >4,000 copies/mg RNA); therapeutic interventions ( cyclosporin A discontinuation, temporary a- interferon or donor lymphocyte infusion) restored molecular remission in 4/9 (44%) cases. INTERPRETATION AND CONCLUSIONS: This study indicates that quantitative PCR could provide practical indications capable of directing therapeutic interventions for transplanted CML patients, especially those transplanted in accelerated/blastic phase, for whom intensive monitoring is required.
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Authors | G Martinelli, V Montefusco, N Testoni, M Amabile, G Saglio, E Ottaviani, C Terragna, F Bonifazi, G Rosti, G Bandini, S Tura |
Journal | Haematologica
(Haematologica)
Vol. 85
Issue 6
Pg. 653-8
(Jun 2000)
ISSN: 0390-6078 [Print] Italy |
PMID | 10870124
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- RNA, Messenger
- Recombinant Fusion Proteins
- Fusion Proteins, bcr-abl
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Topics |
- Adolescent
- Adult
- Blast Crisis
(genetics, therapy)
- Bone Marrow Transplantation
- Cytogenetics
- Disease-Free Survival
- Female
- Fusion Proteins, bcr-abl
(genetics)
- Graft vs Leukemia Effect
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
(genetics, therapy)
- Male
- Middle Aged
- Neoplasm, Residual
(diagnosis, genetics, therapy)
- Polymerase Chain Reaction
- RNA, Messenger
(blood)
- Recombinant Fusion Proteins
(genetics)
- Transplantation, Homologous
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