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Detection of Philadelphia chromosome-positive acute lymphoblastic leukemia
by polymerase chain reaction: possible eradication of minimal residual
disease by marrow transplantation
K Miyamura, M Tanimoto, Y Morishima, K Horibe, K Yamamoto, M Akatsuka, Y Kodera, S Kojima, K Matsuyama and N Hirabayashi
First Department of Internal Medicine and Pediatrics, Nagoya University
School of Medicine, Japan.
Minimal residual disease (MRD) in patients with Philadelphia chromosome-
positive acute lymphoblastic leukemia (Ph1 ALL) who received allogeneic (n
= 9) or autologous (n = 6) bone marrow transplantation (BMT) was evaluated
by the polymerase chain reaction (PCR) for the bcr-abl transcript. Twelve
patients received BMT at the time of hematologic and cytogenetic remission.
However, MRD was detected in 8 of 10 patients evaluated. Seven patients,
including three who had MRD before BMT, continue to have a disease-free
survival 5 to 64 months after BMT. Twenty-one specimens obtained from these
patients at various times after BMT did not show MRD. In three patients,
MRD detected just before BMT seems to be eradicated by BMT protocol. The
other eight patients developed cytogenetic or hematologic relapses 2 to 8
months after BMT. Seven of 14 samples from these patients demonstrated MRD,
which preceded clinical relapse by 3 to 9 weeks. Thus, this technique for
the detection of MRD appears to be useful for the more precise assessment
of various antileukemia therapies and for early detection of leukemia
recurrence.
Volume 79,
Issue 5,
pp. 1366-1370,
03/01/1992
Copyright © 1992 by The American Society of Hematology
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