title: Treatment of Relapsing Ph+ Acute Lymphoblastic Leukemia with Donor Leukocyte Infusion Followed by Quantitative Monitoring of Residual Disease.
abstract: The case of a 34-year-old man with relapsing Ph+ acute lymphoblastic leukemia (ALL), which occurred five months after allogeneic bone marrow transplantation, is described. He was originally treated with aggressive chemotherapy, which put him in hematological remission, and he subsequently received donor leukocyte infusion (DLI) form the original donor. To assess the efficacy of this adoptive immunotherapy, we monitored minor-BCR/ABL (m-BCR/ABL) mRNA levels using the recently established real-time quantitative RT-PCR (RQ-PCR) assay. The results were compared with those obtained using conventional qualitative RT-PCR assays run in parallel. RQ-PCR, but not RT-PCR-based, minimum residual disease (MRD) detection showed a good correlation with the rapid changes documented during the post-DLI clinical course. Currently, six months after DLI, the patient continues to be in remission, which is consistent with the undetectable levels of m-BCR/ABL mRNA in the leukemic clone using RQ-PCR found in this study. Thus, monitoring of m-bcr/abl transcripts using RQ-PCR provides more useful information on a clinical assessment of MRD.
authors.affiliation: a Hematology Division , Tokyo Metropolitan Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 , Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kono
authors.affiliation: a Hematology Division , Tokyo Metropolitan Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 , Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: b Blood Transfusion Service , Tokyo Metropolitan Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 , Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Okuyama
authors.affiliation: a Hematology Division , Tokyo Metropolitan Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 , Japan.
authors.forename: S
authors.initials: S
authors.lastname: Mori
authors.affiliation: b Blood Transfusion Service , Tokyo Metropolitan Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 , Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hiruma
authors.affiliation: a Hematology Division , Tokyo Metropolitan Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 , Japan.
authors.forename: H
authors.initials: H
authors.lastname: Akiyama
authors.affiliation: c Otsuka Assay Laboratories , Otsuka Pharmaceutical Company Limited , Tokyo , Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fukui
authors.affiliation: c Otsuka Assay Laboratories , Otsuka Pharmaceutical Company Limited , Tokyo , Japan.
authors.forename: K
authors.initials: K
authors.lastname: Osumi
authors.affiliation: a Hematology Division , Tokyo Metropolitan Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 , Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sakamaki
keywords: Donor leukocyte infusion; Leukemic relapse; Molecular monitoring; Ph+ ALL; Real-time RT-PCR