[The significance of serial monitoring of bcr-abl transcripts levels after allogeneic hematopoietic stem cell transplantation in screening chronic myeloid leukemia patients with low relapse].
OBJECTIVE
To explore dynamic status of bcr-abl transcript levels in chronic myeloid leukemia (CML) patients after allogeneic HSCT and to define low relapse patients who may not require further therapeutic intervention.


METHODS
One hundred and forty-nine CML cases received allo-HSCT at our Institute between Nov. 2004 and Nov. 2006. Bcr-abl transcripts levels were monitored from bone marrow samples by Q-RT-PCR in all cases pre-HSCT and at 1, 2, 3, 4, 5, 6 months post HSCT. The median value of bcr-abl at these time points were calculated and compared by Mann-Whitney U test. The relapse rate, overall survival (OS) and incidence of graft versus host disease (GVHD) were calculated by Kaplan-Meier curve.


RESULTS
All cases engrafted. 2-year OS rate was 86.0% (CI: 82.9% -89.1%), 2-year accumulated hematological relapse rate (RI) was 3.5% (CI: 1.7% -5.3%). 102 cases were not received any further intervention and none of them relapsed. The median value of bcr-abl transcripts was 25.800% (CI: 0.067% - 96.100%) pre-HSCT and 0.025% (CI: 0 - 3.583%) at +30 d, 0.011% (CI: 0-0.425%) at +60 d, 0.002% (CI: 0 - 0.610%) at +90 d, 0 (CI: 0 - 0.056%) at +120 d post HSCT. The bcr-abl mRNA levels decreased to undetectable level at +3 m, +4 m, and +5 m in recipients from HLA-mismatched related donor, identical sibling donor and unrelated donor respectively.


CONCLUSIONS
Serial monitoring of bcr-abl transcript levels by real-time quantitative PCR after allo-HSCT is helpful for screening CML patients with low risk of relapse.
Xu
Lan-Ping
LP
Peking University Institute of Hematology, Peking University People's Hospital, Beijing 100044, China.
Liu
Kai-Yan
KY
Huang
Xiao-Jun
XJ
Liu
Dai-Hong
DH
Han
Wei
W
Chen
Yu-Hong
YH
Wang
Yu
Y
Liu
Yan-Rong
YR
Qin
Ya-Zhen
YZ
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D016044:Fusion Proteins, bcr-abl / Q000378:metabolism*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000378:metabolism* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult
D016044:Fusion Proteins, bcr-abl