Clinical value of quantitative long-term assessment of bcr-abl chimeric transcript in chronic myelogenous leukemia patients after allogeneic bone marrow transplantation

Giovanni Martinelli, Vittorio Montefusco, Nicoletta Testoni, Marilina Amabile, Giuseppe Saglio, Emanuela Ottaviani, Carolina Terragna, Francesca Bonifazi, Gianantonio Rosti, Giuseppe Bandini, Sante Tura

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Abstract

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.

Original languageEnglish
Pages (from-to)653-658
Number of pages6
JournalHaematologica
Volume85
Issue number6
Publication statusPublished - Jun 2000

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Keywords

  • Chronic myelogenous leukemia
  • DLI
  • Minimal residual disease
  • Q-PCR

ASJC Scopus subject areas

  • Hematology

Cite this

Martinelli, G., Montefusco, V., Testoni, N., Amabile, M., Saglio, G., Ottaviani, E., Terragna, C., Bonifazi, F., Rosti, G., Bandini, G., & Tura, S. (2000). Clinical value of quantitative long-term assessment of bcr-abl chimeric transcript in chronic myelogenous leukemia patients after allogeneic bone marrow transplantation. Haematologica, 85(6), 653-658.