Faculty Collaboration Database

Detection of BCR/ABL RNA transcripts using the polymerase chain reaction is highly predictive for relapse in patients transplanted with unrelated marrow grafts for chronic myelogenous leukaemia. Br J Haematol 1997 Aug;98(2):458-66

Date

08/01/1997

Pubmed ID

9266951

DOI

10.1046/j.1365-2141.1997.2223039.x

Scopus ID

2-s2.0-0030873760 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

Relapse after allogeneic bone marrow transplantation (BMT) for chronic myelogenous leukaemia (CML) is thought to result from residual leukaemia cells which survive the intensive conditioning regimen and are not eradicated by donor-derived immune effector cells capable of mediating a graft-versus-leukaemia (GVL) effect. Early relapse can be detected using highly sensitive assays such as the polymerase chain reaction (PCR) which have been shown to have predictive value for subsequent relapse in selected patient populations. The validity of PCR for predicting CML relapse in unrelated marrow transplant recipients where the GVL effect appears to be augmented due to increased HLA disparity between donor and recipient, however, has not been well defined. In this study we assessed the prognostic value of PCR in a cohort of 52 patients transplanted with T-cell-depleted unrelated marrow grafts for CML. The actual probability of relapse at 3 years was 71% in patients with at least one positive assay versus 6% in patients with no positive assays post-transplant. Patients with one or more positive assays at any time post-transplant had a 56-fold increased risk of relapse which was significantly higher (P=0.0002) than that observed in patients who remained persistently PCR negative. Moreover, PCR detected relapse a median of 5 months earlier than cytogenetic analysis in a subgroup of patients in whom concurrent sampling had been performed. These data validate the use of PCR as a prognostic test in this patient population and may help to identify a cohort of patients to be considered as candidates for pre-emptive adoptive immunotherapy.

Author List

Drobyski WR, Endean DJ, Klein JP, Hessner MJ

Authors

William R. Drobyski MD Professor in the Medicine department at Medical College of Wisconsin
Martin J. Hessner PhD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Bone Marrow Transplantation
Female
Fusion Proteins, bcr-abl
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Longitudinal Studies
Male
Neoplasm, Residual
Polymerase Chain Reaction
RNA, Messenger
RNA, Neoplasm
Recurrence
Transplantation, Homologous