Combined RT-PCR and metaphase-FISH posttransplant studies in pediatric patients with chronic myeloid leukemia.
OBJECTIVE
To evaluate the use of a combined reverse-transcriptase polymerase chain reaction (RT-PCR) and metaphase fluorescent in situ hybridization (FISH) approach post-allogeneic marrow transplant in the detection of relapse in pediatric patients with chronic myeloid leukemia (CML).


METHODS
Five pediatric patients with CML were monitored post-allogeneic transplant (two of them also had received donor lymphocyte infusions) using the combined approach of RT-PCR and metaphase FISH. Both the transplants and the follow-up were carried out in a single institution setting.


RESULTS
During the posttransplant evaluation, a transiently positive signal for the Philadelphia chromosome but no transcription of the bcr/abl-fusion message was detected in one patient currently in remission. A posttransplant relapse was detected in two patients who demonstrated the Philadelphia chromosome and the bcr/abl-fusion transcript; one was successfully treated with donor lymphocyte infusions. The two patients consistently negative for both the Philadelphia chromosome and the bcr/abl-fusion transcript and currently in remission.


CONCLUSIONS
Pediatric patients with CML may transiently demonstrate cells positive for the Philadelphia chromosome but not actively transcribing the bcr/abl-fusion message in their marrow during their posttransplant evaluation but remain in remission. Recurrence is highly likely in patients demonstrating positivity for both; these patients may be considered candidates for donor lymphocyte transfusion therapy.
Vettenranta
K
K
Division of Hematology-Oncology, Hospital for Children and Adolescents, University of Helsinki, Finland.
Huhta
T
T
Lindlöf
M
M
Knuutila
S
S
Saarinen-Pihkala
U M
UM
D000293:Adolescent; D016026:Bone Marrow Transplantation; D002455:Cell Division / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology* / Q000628:therapy*; D008677:Metaphase / Q000502:physiology; D010865:Pilot Projects; D016133:Polymerase Chain Reaction / Q000379:methods*; D014158:Transcription, Genetic