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Risk factors for adults with Philadelphia-chromosome-positive acute lymphoblastic leukaemia in remission treated with allogeneic bone marrow transplantation: the potential of real-time quantitative reverse-transcription polymerase chain reaction.

Abstract
The aim of this study was to evaluate the outcomes for Philadelphia-chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) patients in remission treated with allogeneic bone marrow transplantation (BMT). Twenty-three adults were entered onto this study. The 2-year probabilities of relapse and disease-free survival (DFS) were 39.4 +/- 11.6% and 43.5 +/- 10.3% respectively. The presence of chronic graft-versus-host disease (GVHD) was found to be an independent predictive factor affecting lower relapse and DFS. To monitor the BCR-ABL transcript, we also analysed 48 bone marrow samples of eight patients using real-time quantitative reverse-transcription polymerase chain reaction (RT-PCR). The kinetics of the BCR-ABL transcript correlated well with the patients' clinical course. In six patients who were in continuous remission after BMT, a rapid decrease in BCR-ABL copy number to the PCR-negative status was observed after the development of chronic GVHD. Meanwhile, routine bone marrow examination of two patients showed PCR positivity with a 3 or 4-log increase of BCR-ABL copy number and subsequent haematological relapse, which occurred 2 and 4 months later respectively. Although our data should be interpreted cautiously, the presence of chronic GVHD may reduce the risk of relapse in Ph+ ALL. Real-time quantitative RT-PCR appears to be a useful test for BCR-ABL transcript monitoring.
AuthorsSeok Lee, Dong-Wook Kim, Bin Cho, Yoo-Jin Kim, Yoo-Li Kim, Ji-Yeon Hwang, Yoon-Hee Park, Ho-Jin Shin, Chi-Young Park, Woo-Sung Min, Hack-Ki Kim, Chun-Choo Kim
JournalBritish journal of haematology (Br J Haematol) Vol. 120 Issue 1 Pg. 145-53 (Jan 2003) ISSN: 0007-1048 [Print] England
PMID12492591 (Publication Type: Journal Article)
Topics
  • Adult
  • Bone Marrow Transplantation
  • Disease-Free Survival
  • Female
  • Genes, abl
  • Graft vs Host Disease
  • Humans
  • Male
  • Middle Aged
  • Neoplasm, Residual
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (genetics, therapy)
  • Predictive Value of Tests
  • Probability
  • Proportional Hazards Models
  • Recurrence
  • Remission Induction
  • Reverse Transcriptase Polymerase Chain Reaction
  • Risk Factors
  • Transplantation, Homologous

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