title: NCI first international workshop on the biology, prevention, and treatment of relapse after allogeneic hematopoietic stem cell transplantation: report from the committee on disease-specific methods and strategies for monitoring relapse following allogeneic stem cell transplantation. part II: chronic leukemias, myeloproliferative neoplasms, and lymphoid malignancies.
abstract: Relapse has become the major cause of treatment failure after allogeneic hematopoietic stem cell transplantation. Outcome of patients with clinical relapse after transplantation generally remains poor, but intervention prior to florid relapse improves outcome for certain hematologic malignancies. To detect early relapse or minimal residual disease, sensitive methods such as molecular genetics, tumor-specific molecular primers, fluorescence in situ hybridization (FISH), and multiparameter flow cytometry (MFC) are commonly used after allogeneic stem cell transplantation to monitor patients, but not all of them are included in the commonly employed disease-specific response criteria. The highest sensitivity and specificity can be achieved by molecular monitoring of tumor- or patient-specific markers measured by polymerase chain reaction-based techniques, but not all diseases have such targets for monitoring. Similar high sensitivity can be achieved by determination of recipient-donor chimerism, but its specificity regarding detection of relapse is low and differs substantially among diseases. Here, we summarize the current knowledge about the utilization of such sensitive monitoring techniques in chronic leukemias, myeloproliferative neoplasms, and lymphoid malignancies based on tumor-specific markers and cell chimerism and how these methods might augment the standard definitions of posttransplant remission, persistence, progression, relapse, and the prediction of relapse. Critically important is the need for standardization of the different residual disease techniques and to assess the clinical relevance of minimal residual disease and chimerism surveillance in individual diseases, which in turn must be followed by studies to assess the potential impact of specific interventional strategies.
authors.affiliation: Department for Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Germany. nkroeger@uke.uni-hamburg.du
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bacher
authors.forename: Peter
authors.initials: P
authors.lastname: Bader
authors.forename: Sebastian
authors.initials: S
authors.lastname: Böttcher
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Borowitz
authors.forename: Peter
authors.initials: P
authors.lastname: Dreger
authors.forename: Issa
authors.initials: I
authors.lastname: Khouri
authors.forename: Eduardo
authors.initials: E
authors.lastname: Olavarria
authors.forename: Jerald
authors.initials: J
authors.lastname: Radich
authors.forename: Wendy
authors.initials: W
authors.lastname: Stock
authors.forename: Julie M
authors.initials: JM
authors.lastname: Vose
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisdorf
authors.forename: Andre
authors.initials: A
authors.lastname: Willasch
authors.forename: Sergio
authors.initials: S
authors.lastname: Giralt
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bishop
authors.forename: Alan S
authors.initials: AS
authors.lastname: Wayne
mesh_terms: D014408:Biomarkers, Tumor; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery*; D008223:Lymphoma / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery*; D025202:Molecular Diagnostic Techniques; D009196:Myeloproliferative Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery*; D018365:Neoplasm, Residual; D011237:Predictive Value of Tests; D055502:Secondary Prevention; D014184:Transplantation, Homologous
chemical_list: D014408:Biomarkers, Tumor