Risk factors for adults with Philadelphia-chromosome-positive acute lymphoblastic leukaemia in remission treated with allogeneic bone marrow transplantation: the potential of real-time quantitative reverse-transcription polymerase chain reaction.
The aim of this study was to evaluate the outcomes for Philadelphia-chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) patients in remission treated with allogeneic bone marrow transplantation (BMT). Twenty-three adults were entered onto this study. The 2-year probabilities of relapse and disease-free survival (DFS) were 39.4 +/- 11.6% and 43.5 +/- 10.3% respectively. The presence of chronic graft-versus-host disease (GVHD) was found to be an independent predictive factor affecting lower relapse and DFS. To monitor the BCR-ABL transcript, we also analysed 48 bone marrow samples of eight patients using real-time quantitative reverse-transcription polymerase chain reaction (RT-PCR). The kinetics of the BCR-ABL transcript correlated well with the patients' clinical course. In six patients who were in continuous remission after BMT, a rapid decrease in BCR-ABL copy number to the PCR-negative status was observed after the development of chronic GVHD. Meanwhile, routine bone marrow examination of two patients showed PCR positivity with a 3 or 4-log increase of BCR-ABL copy number and subsequent haematological relapse, which occurred 2 and 4 months later respectively. Although our data should be interpreted cautiously, the presence of chronic GVHD may reduce the risk of relapse in Ph+ ALL. Real-time quantitative RT-PCR appears to be a useful test for BCR-ABL transcript monitoring.
Lee
Seok
S
Catholic Haematopoietic Stem Cell Transplantation Centre, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Kim
Dong-Wook
DW
Cho
Bin
B
Kim
Yoo-Jin
YJ
Kim
Yoo-Li
YL
Hwang
Ji-Yeon
JY
Park
Yoon-Hee
YH
Shin
Ho-Jin
HJ
Park
Chi-Young
CY
Min
Woo-Sung
WS
Kim
Hack-Ki
HK
Kim
Chun-Choo
CC
D000328:Adult; D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D005260:Female; D016313:Genes, abl; D006086:Graft vs Host Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000628:therapy*; D011237:Predictive Value of Tests; D011336:Probability; D016016:Proportional Hazards Models; D012008:Recurrence; D012074:Remission Induction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D014184:Transplantation, Homologous