title: 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.
abstract: 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.
authors.affiliation: Catholic Haematopoietic Stem Cell Transplantation Centre, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Lee
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Bin
authors.initials: B
authors.lastname: Cho
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Yoo-Li
authors.initials: YL
authors.lastname: Kim
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Hwang
authors.forename: Yoon-Hee
authors.initials: YH
authors.lastname: Park
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Chi-Young
authors.initials: CY
authors.lastname: Park
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Min
authors.forename: Hack-Ki
authors.initials: HK
authors.lastname: Kim
authors.forename: Chun-Choo
authors.initials: CC
authors.lastname: Kim
mesh_terms: 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