TY - JOUR
T1 - Quantitative PCR of bone marrow BCL2/IgH+ cells at diagnosis predicts treatment response and long-term outcome in follicular non-Hodgkin lymphoma
AU - Rambaldi, Alessandro
AU - Carlotti, Emanuela
AU - Oldani, Elena
AU - Della Starza, Irene
AU - Baccarani, Michele
AU - Cortelazzo, Sergio
AU - Lauria, Francesco
AU - Arcaini, Luca
AU - Morra, Enrica
AU - Pulsoni, Alessandro
AU - Rigacci, Luigi
AU - Rupolo, Maurizio
AU - Zaja, Francesco
AU - Zinzani, Pier Luigi
AU - Barbui, Tiziano
AU - Foa, Robert
PY - 2005/5/1
Y1 - 2005/5/1
N2 - By real-time quantitative polymerase chain reaction (RQ-PCR), we evaluated BCL2/IgH+ cells in the bone marrow (BM) and peripheral blood (PB) from 86 patients with follicular lymphoma treated with the sequential administration of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) and rituximab. At diagnosis, the amount of BCL2/IgH+ cells In the BM was low (1 BCL2/IgH+ cell in 1000-100 000 normal cells) in 43% of patients, intermediate (1 in 100-1000) in 34%, and high (> 1 in 100) in 23%. A 2 log decrease of BCL2/IgH+ cells was achieved after CHOP and an additional 2 log reduction following rituximab. By multivariate analysis, a low level of BCL2/IgH+ cells in the BM at diagnosis was the best predictor for the achievement of a complete clinical and molecular response. At 5 years, the event-free survival rates of patients with a low/intermediate or high tumor infiltration in the BM were 59% and 32%, respectively. The freedom from recurrence of patients who achieved a molecular response in the BM, no matter whether after CHOP alone or CHOP and rituximab, was 64% as compared to 32% for patients who did not (P <.006). RQ-PCR performed at presentation on BM samples predicts treatment response and long-term clinical outcome in patients with follicular lymphoma.
AB - By real-time quantitative polymerase chain reaction (RQ-PCR), we evaluated BCL2/IgH+ cells in the bone marrow (BM) and peripheral blood (PB) from 86 patients with follicular lymphoma treated with the sequential administration of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) and rituximab. At diagnosis, the amount of BCL2/IgH+ cells In the BM was low (1 BCL2/IgH+ cell in 1000-100 000 normal cells) in 43% of patients, intermediate (1 in 100-1000) in 34%, and high (> 1 in 100) in 23%. A 2 log decrease of BCL2/IgH+ cells was achieved after CHOP and an additional 2 log reduction following rituximab. By multivariate analysis, a low level of BCL2/IgH+ cells in the BM at diagnosis was the best predictor for the achievement of a complete clinical and molecular response. At 5 years, the event-free survival rates of patients with a low/intermediate or high tumor infiltration in the BM were 59% and 32%, respectively. The freedom from recurrence of patients who achieved a molecular response in the BM, no matter whether after CHOP alone or CHOP and rituximab, was 64% as compared to 32% for patients who did not (P <.006). RQ-PCR performed at presentation on BM samples predicts treatment response and long-term clinical outcome in patients with follicular lymphoma.
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U2 - 10.1182/blood-2004-06-2490
DO - 10.1182/blood-2004-06-2490
M3 - Article
C2 - 15637137
AN - SCOPUS:20944439288
VL - 105
SP - 3428
EP - 3433
JO - Blood
JF - Blood
SN - 0006-4971
IS - 9
ER -