Molecular detection of residual lymphoma cells in peripheral blood stem cell harvests and following autologous transplantation.
Twenty-seven patients with non-Hodgkin's lymphoma (NHL) have undergone peripheral blood stem cell (PBSC) harvesting for autologous transplantation (Tx). A molecular marker was found at presentation in 23/27 patients. Immunoglobulin heavy chain (IgH) or T cell receptor beta (TCR beta) rearrangements were detected by Southern blotting or the polymerase chain reaction (PCR) in 13 patients; PCR detected the bcl-2/JH fusion in 10 patients. Fifteen autologous PBSC transplants have been performed in 11 patients. In 5/11 patients, the marker was present in at least one PBSC collection (in four patients, every PBSC collection was positive). Survival data are available for nine patients (two early deaths); three patients relapsed and died (221 - 930 d), one is alive and in relapse (354 + d) and five are alive and in complete remission (330 - 1290 + d). These findings suggest that tumour cell contamination of PBSC harvests is not uncommon. Whether these cells are clonogenic and contribute to disease relapse remains to be elucidated. The presence of residual disease at the time of transplantation and the reappearance (or persistence) of marker positive cells post-transplantation both appear to be poor prognostic factors for disease-free survival.
Department of Haematology-Oncology, Queen Elizabeth Hospital, Woodville Australia.
J E
JE
Hardingham
D
D
Kotasek
R E
RE
Sage
A
A
Dobrovic
T
T
Gooley
B M
BM
Dale
D000328:Adult; D001483:Base Sequence; D014408:Biomarkers, Tumor; D001773:Blood Cells / Q000276:immunology / Q000473:pathology; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods / Q000473:pathology*; D003001:Cloning, Molecular; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D006412:Hematopoietic Stem Cells / Q000276:immunology / Q000473:pathology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009360:Neoplastic Cells, Circulating / Q000276:immunology / Q000473:pathology; D016133:Polymerase Chain Reaction; D011379:Prognosis; D014182:Transplantation, Autologous
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm