title: T-cell receptor excision circles: a novel prognostic parameter for the outcome of transplantation in multiple myeloma patients.
abstract: This study investigated whether T-cell receptor excision circles (TRECs) are a prognostic marker for the outcome of myeloma patients undergoing a tandem autologous peripheral blood stem cell transplantation (PBSCT). Twenty-five patients were enrolled. Samples were obtained at study enrollment, after conventional therapy, between first and second transplantation and 3, 6, 12 and 24 months after the second PBSCT. TRECs were quantified using real-time polymerase chain reaction. A high variation in TREC levels was found at diagnosis (median TREC level 136/10(5) peripheral blood mononuclear cells (PBMCs); range 1-1729), suggesting individual differences in thymic output of naive T cells. Patients with more than 136 TRECs/10(5) P BMCs at diagnosis had a statistically significant better overall survival (P=0.05) and event-free survival (P=0.045), whereas low TREC levels correlated with a higher incidence of infectious complications. Median TREC values were lowest after the first PBSCT (52/10(5) PBMCs) and reached the baseline 12 months after the second transplantation. Patients with high TREC levels after the second PBSCT had a significantly higher probability of being in complete or partial remission 30 months after the second PBSCT. TREC levels were not correlated with beta2-microglobulin and C-reactive protein levels at diagnosis. These data suggest that TRECs could be a relevant prognostic factor for patients who receive high-dose chemotherapy and autologous PBSCT.
authors.affiliation: Department of Hematology and Bone Marrow Transplantation Centre, Regional Hospital, Bozen, Italy. mirija.svaldi@asbz.it
authors.forename: Mirija
authors.initials: M
authors.lastname: Svaldi
authors.forename: Andrea Judith
authors.initials: AJ
authors.lastname: Lanthaler
authors.forename: Martin
authors.initials: M
authors.lastname: Dugas
authors.forename: Peter
authors.initials: P
authors.lastname: Lohse
authors.forename: Norbert
authors.initials: N
authors.lastname: Pescosta
authors.forename: Christian
authors.initials: C
authors.lastname: Straka
authors.forename: Manfred
authors.initials: M
authors.lastname: Mitterer
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte; D019672:Genes, T-Cell Receptor; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000235:genetics* / Q000401:mortality / Q000601:surgery*; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D012086:Reoperation; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014182:Transplantation, Autologous; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D015415:Biomarkers; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein