BCR-ABL transcripts are early predictors for hematological relapse in chronic myeloid leukemia after hematopoietic cell transplantation with reduced intensity conditioning

Leukemia
Thoralf LangeDietger Niederwieser

Abstract

Kinetics of BCR-ABL transcript elimination and its prognostic implications on relapse were analyzed in patients with chronic myeloid leukemia (CML) after reduced intensity hematopoietic cell transplantation (HCT). In all, 19 CML patients were conditioned with 2 Gy total-body irradiation in combination with (n=14) or without (n=3) fludarabine 3 x 30 mg/m(2) (Flu) or 4.5 Gy total lymphoid irradiation (TLI) with Flu and OKT3 3 x 5 mg (n=2) and were treated with cyclosporine (CSP) and mycophenolate mofetil after allogeneic HCT. BCR-ABL transcripts were analyzed by nested RT-PCR and Taqman((R)) RT-PCR on days +28, +56 and +84 after HCT and were evaluated for their association with relapse. Of the 19 patients, 14 achieved sustained remissions of which six had a negative RT-PCR 28 days after HCT. Five patients relapsed +41, +54, +57, +136 and +234 days after HCT. Predictors for relapse were advanced disease stage (P=0.02) and slow reduction of BCR-ABL transcripts at day 28 (P=0.006) and day 56 (P=0.047) post-transplant. We conclude that a complete clearance of BCR-ABL transcripts is achievable within 4 weeks from HCT even after minimal conditioning and that early kinetics of BCR-ABL transcripts significantly correlate with the probabi...Continue Reading

References

Jan 23, 1986·The New England Journal of Medicine·J M GoldmanJ Hows
Feb 1, 1986·Annals of Internal Medicine·E D ThomasK Doney

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Citations

Jul 28, 2012·Stem Cell Reviews and Reports·S Abdul Wahid Fadilah, Md Pazil Aqilah
Apr 13, 2010·Expert Review of Hematology·Aravind Ramakrishnan, Brenda M Sandmaier
Mar 1, 2010·Expert Opinion on Medical Diagnostics·Thoralf Lange, Michael W Deininger
Sep 13, 2005·Clinica Chimica Acta; International Journal of Clinical Chemistry·Frank Schüler, Gottfried Dölken
Apr 7, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Frédéric BaronRainer Storb
Aug 10, 2010·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Xiao-Jun HuangYu Wang

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