Minimal residual disease may predict bone marrow relapse in patients with hairy cell leukemia treated with 2-chlorodeoxyadenosine.
Minimal residual disease (MRD) can be detected in bone marrow core biopsies of patients with hairy cell leukemia (HCL) after treatment with 2-chlorodeoxyadenosine (2-CdA) using immunohistochemical (IHC) techniques. The purpose of this study was to determine whether the presence of MRD predicts bone marrow relapse. We studied paraffin-embedded bone marrow core biopsies from 39 patients with HCL in complete remission (CR) 3 months after a single cycle of 2-CdA. Biopsies performed 3 months posttherapy and annually thereafter were examined by routine hematoxylin and eosin (H&E) staining and IHC using the monoclonal antibodies (MoAbs) anti-CD45RO, anti-CD20, and DBA.44. At 3 months after therapy, 5 of 39 (13%) patients had MRD detectable by IHC that was not evident by routine H&E staining. Two of the five patients (40%) with MRD at 3 months have relapsed, whereas only 2 of 27 (7%) patients with no MRD and at least 1 year of follow up relapsed (P = .11). Over the 3-year follow-up period, two additional patients developed MRD. Overall, three of six (50%) patients with MRD detected at any time after therapy have relapsed, whereas only 1 of 25 (4%) patients without MRD has relapsed (P = .016). These data suggest that the presence of MRD after treatment with 2-CdA may predict relapse.
Wheaton
S
S
Department of Pathology Northwestern University Medical School, Chicago, IL 60611, USA.
Tallman
M S
MS
Hakimian
D
D
Peterson
L
L
D000911:Antibodies, Monoclonal; D018951:Antigens, CD20 / Q000032:analysis; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D017338:Cladribine / Q000627:therapeutic use; D006801:Humans; D007120:Immunochemistry; D007943:Leukemia, Hairy Cell / Q000175:diagnosis* / Q000188:drug therapy; D018365:Neoplasm, Residual / Q000175:diagnosis*; D011379:Prognosis; D013997:Time Factors
D000911:Antibodies, Monoclonal; D018951:Antigens, CD20; D000964:Antimetabolites, Antineoplastic; D017338:Cladribine