Clinical significance of bcr-abl gene rearrangement detected by polymerase chain reaction after allogeneic bone marrow transplantation in chronic myelogenous leukemia.

摘要: In chronic myelogenous leukemia (CML), amplification of a segment bcr-abl messenger RNA (mRNA) by polymerase chain reaction (PCR) can be used to detect minimal residual disease after bone marrow transplantation (BMT). Previous studies have shown that this sensitive technique often small numbers cells in patients who are otherwise complete remission. Nevertheless, the clinical significance PCR positivity remains unclear because majority with PCR-detectable mRNA remain disease-free for prolonged periods allogeneic BMT. present studies, we applied bcr-abl-positive 100 serial blood or BM samples from 24 CML underwent CD6 T-cell-depleted After BMT, could detected 20 (83.3%) during cytogenetic Patients whom was sustained over time had higher probability relapse than intermittently negative (P = .0095, log rank test). detection transcript between 2 and 10 weeks post-BMT also associated high subsequent .023, eight selected patients, titration assay PCR-amplified product estimate number tumor each sample post-BMT. results four showed continuing increase early posttransplant until either conventional methods 1 years later. contrast, no relatively low stable throughout follow-up period remained These show BMT has important prognostic value. Estimation analyses proliferation leukemic population. Sensitive assess effectiveness transplant preparative regimen direct evaluate further therapy post-BMT, before development overt relapse.