Early PCR-negativity after allogeneic BMT in adults with t(4;11) ALL in the absence of acute or chronic GVHD.
Acute lymphoblastic leukaemia (ALL) with the t(4;11) translocation has a very poor prognosis following conventional chemotherapy. Many patients are offered an allogeneic BMT in first remission. We report on the impact of allogeneic BMT on three patients with t(4;11) ALL in first remission. Median age was 20 years. One patient received marrow from an HLA-identical sibling and the other two from unrelated donors. All three engrafted and none of the patients developed acute or chronic GVHD. Remission status was monitored using a sensitive nested RT-PCR to detect the ALL-1/AF-4 hybrid transcript. All three were PCR-negative at 3 months post-BMT. One of the unrelated recipients died of a fungal infection 4 months post-BMT. The other two are alive and in molecular remission at 21 and 24 months post-BMT. This is the first report of longitudinal follow-up of t(4;11) ALL post-allogeneic BMT by PCR. The early attainment of molecular remission in the absence of GVHD suggests that the conditioning regimen may have been more important than a graft-versus-leukaemia effect in these patients. Follow-up of larger numbers of patients will be required to confirm these preliminary observations.
D'Sa
S
S
Department of Haematology, University College London, UK.
Verfuerth
S
S
Vyas
P
P
Langabeer
S
S
Perry
A
A
Peniket
A
A
Mackinnon
S
S
D000208:Acute Disease; D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology; D002880:Chromosomes, Human, Pair 11; D002894:Chromosomes, Human, Pair 4; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D016133:Polymerase Chain Reaction; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics*; D012074:Remission Induction; D014178:Translocation, Genetic