[The monitoring of BCR-ABL mRNA by reverse transcription PCR in patients undergoing allogeneic bone marrow transplantation for acute lymphoblastic leukemia with a positive Philadelphia chromosome].
BACKGROUND
Allogeneic bone marrow transplantation (BMT) has been performed as one mode of cure-oriented therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL-Ph' positive). However, the clinical significance of the residual BCR-ABL-positive clones after BMT is still controversial.


METHODS
The BCR-ABL gene (p210 and p190) was prospectively studied by nested RT-PCR in 8 ALL-Ph' positive patients undergoing BMT.


RESULTS
All patients received BMT at the time of clinical remission (CR). However, minimal residual disease (MRD) was detected in 7 of them. MRD detected just before BMT seems to be eradicated by BMT protocol. Four patients remained in CR and did not show BCR-ABL transcripts. Other 4 patients, relapsed, demonstrating MRD, which preceded recurrence by a median time of 6 weeks. Three relapsed patients showed p190 transcript and only one, p210 type.


CONCLUSIONS
The RT-PCR assay appears to be a useful test for predicting at high risk of relapse after BMT and may identify patients who might benefit from therapeutic interventions. The finding that the expression of p190 BCR-ABL may carry an especially high risk of relapse suggests a different clinical and biologic behaviour between p190 and p210 BCR-ABL.
Román
J
J
Servicio de Hematología, Hospital Reina Sofía, Córdoba. peperosa@teleline.es
Castillejo
J A
JA
Jiménez
A
A
Maldonado
J
J
Torres
A
A
D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000032:analysis* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000032:analysis* / Q000235:genetics; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D014184:Transplantation, Homologous
D012333:RNA, Messenger; D016044:Fusion Proteins, bcr-abl