Background and Objectives. For purposes of therapeutic decision making, we used quantitative polymerase chain reaction (PCR) for molecular follow-up of 55 patients with chronic myeloid leukemia (CML) in complete remission (CR) after allogeneic bone marrow transplantation (BMT) from HLA compatible donors. 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%; p1 year after BMT was significantly lower in group 1 patients (4/40 patients, 10% vs. 9/15 patients, 60%; p = 0.01). At quantitative PCR, 4/8 (50%) group 1 patients were positive only once (<400 transcripts/μg RNA). In group 2, 9/15 (60%) patients had 3 or more positive samples (always with >4,000 coples/mg RNA); therapeutic interventions (cyclosporin A discontinuation, temporary α-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. (C) 2000, Ferrata Storti Foundation.
|Number of pages||6|
|Publication status||Published - Jun 2000|
- Chronic myelogenous leukemia
- Minimal residual disease
ASJC Scopus subject areas