Peripheral blood vs. bone marrow for molecular monitoring of BCR-ABL1 levels in chronic myelogenous leukemia, a retrospective analysis in allogeneic bone marrow recipients.
Molecular monitoring of the BCR-ABL1 transcript in chronic myelogenous leukemia (CML) using quantitative real-time PCR (RQ-PCR) can be performed using either bone marrow (BM) or peripheral blood (PB). However, a recent report by Stock et al. [International Journal of Oncology 28 (2006) 1099] questioned the reliability of PB samples for BCR-ABL1 detection as performed by RQ-PCR. We report a study on 114 CML patients who received allogeneic stem cell transplantation (ASCT), and who were monitored by RQ-PCR using paired samples of BM and PB: the total number of determinations was 428, with a median follow-up after transplant of 8 years. BCR-ABL1 transcript was undetectable or <0.1%, in 106 (49.57%) and 62 (29%) paired determinations, respectively. BCR-ABL1 was >0.1% in 36 (16.8%) paired determinations and was discordant in 10 (4.7%). Agreement between PB and BM results was quantified by the kappa test (k = 0.85; 95% CI 0.76-0.94). This study shows that BCR-ABL1 RQ-PCR monitoring of CML patients after ASCT with PB is concordant with BM in 95.3% of cases, and thus may be used to monitor the disease. This may be relevant when discussing both quality of life issues and the need for post-transplant monitoring with the patient.
Ballestrero
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A
Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, Genoa, Italy. aballestrero@unige.it
Cirmena
G
G
Dominietto
A
A
Garuti
A
A
Rocco
I
I
Cea
M
M
Moran
E
E
Nencioni
A
A
Miglino
M
M
Raiola
A M
AM
Bacigalupo
A
A
Patrone
F
F
D000293:Adolescent; D000328:Adult; D001853:Bone Marrow / Q000473:pathology*; D016026:Bone Marrow Transplantation; D002648:Child; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000097:blood* / Q000235:genetics*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000235:genetics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014184:Transplantation, Homologous; D055815:Young Adult
D016044:Fusion Proteins, bcr-abl