Quantitative PCR of bone marrow BCL2/IgH+ cells at diagnosis predicts treatment response and long-term outcome in follicular non-Hodgkin lymphoma

Alessandro Rambaldi, Emanuela Carlotti, Elena Oldani, Irene Della Starza, Michele Baccarani, Sergio Cortelazzo, Francesco Lauria, Luca Arcaini, Enrica Morra, Alessandro Pulsoni, Luigi Rigacci, Maurizio Rupolo, Francesco Zaja, Pier Luigi Zinzani, Tiziano Barbui, Robert Foa

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)3428-3433
Number of pages6
JournalBlood
Volume105
Issue number9
DOIs
Publication statusPublished - May 1 2005

ASJC Scopus subject areas

  • Hematology

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