Graft-versus-leukemia activity may overcome therapeutic resistance of chronic lymphocytic leukemia with unmutated immunoglobulin variable heavy-chain gene status: implications of minimal residual disease measurement with quantitative PCR.
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| Abstract |
The aim of this study was to investigate if graft-versus-leukemia (GVL) activity conferred by allogeneic stem cell transplantation (allo-SCT) is effective in chronic lymphocytic leukemia (CLL) with unmutated V(H) gene status. The kinetics of residual disease (MRD) were measured by quantitative allele-specific immunoglobulin heavy chain (IgH) polymerase chain reaction (PCR) in 9 patients after nonmyeloablative allo-SCT for unmutated CLL. Despite an only modest decrease in the early posttransplantation phase, MRD became undetectable in 7 of 9 patients (78%) from day +100 onwards subsequent to chronic graft-versus-host disease or donor lymphocyte infusions. With a median follow-up of 25 months (range, 14-37 months), these 7 patients remain in continuous clinical and molecular remission. In contrast, PCR negativity was achieved in only 6 of 26 control patients (23%) after autologous SCT for unmutated CLL and it was not durable. Taken together, this study shows for the first time that GVL-mediated immunotherapy might be effective in CLL with unmutated V(H).
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| Authors | Matthias Ritgen, Stephan Stilgenbauer, Nils von Neuhoff, Andreas Humpe, Monika Brüggemann, Christiane Pott, Thorsten Raff, Alexander Kröber, Donald Bunjes, Richard Schlenk, Norbert Schmitz, Hartmut Döhner, Michael Kneba, Peter Dreger |
| Journal | Blood (Blood) Vol. 104 Issue 8 Pg. 2600-2 (Oct 15 2004) ISSN: 0006-4971 [Print] United States |
| PMID | 15205268 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't) |
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