| In search of the original leukemic clone in chronic myeloid leukemia patients in complete molecular remission after stem cell transplantation or imatinib. | |
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MedLine Citation:
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PMID: 20462961 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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It is not clear if absence of BCR-ABL transcripts--complete molecular response (CMR)--is synonymous with, or required for, cure of chronic myeloid leukemia (CML). Some patients achieve CMR with imatinib (IM), but most relapse shortly after treatment discontinuation. Furthermore, most patients in long-term remission (LTR) post-stem cell transplantation (SCT) are considered functionally cured, although some remain occasionally positive for low-level BCR-ABL mRNA. Interpretation of the latter is complicated because it has been observed in healthy subjects. We designed a patient-specific, highly sensitive, DNA quantitative polymerase chain reaction to test follow-up samples for the original leukemic clone, identified by its unique genomic BCR-ABL fusion (gBCR-ABL). In 5 IM-treated patients in CMR, gBCR-ABL was detected in transcript-negative samples; 4 patients became gBCR-ABL-negative with continuing IM therapy. In contrast, of 9 patients in LTR (13-27 years) post-SCT, gBCR-ABL was detected in only 1, despite occasional transcript-positive samples in 8 of them. In conclusion, in IM-treated patients, absence of transcripts should not be interpreted as absence of the leukemic clone, although continuing IM after achievement of CMR may lead to further reduction of residual disease. Post-SCT, we found little evidence that the transcripts occasionally detected originate from the leukemic clone. |
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Authors:
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Manuel Sobrinho-Simões; Vicki Wilczek; Joannah Score; Nicholas C P Cross; Jane F Apperley; Junia V Melo |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-05-12 |
Journal Detail:
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Title: Blood Volume: 116 ISSN: 1528-0020 ISO Abbreviation: Blood Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-27 Completed Date: 2010-09-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7603509 Medline TA: Blood Country: United States |
Other Details:
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Languages: eng Pagination: 1329-35 Citation Subset: AIM; IM |
Affiliation:
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Department of Haematology, Imperial College London, London, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antineoplastic Agents / therapeutic use* Combined Modality Therapy Female Fusion Proteins, bcr-abl / genetics Graft vs Host Disease / genetics, prevention & control Humans Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis, genetics, therapy* Male Middle Aged Neoplasm Recurrence, Local / diagnosis, genetics, therapy* Neoplasm, Residual / diagnosis, genetics, therapy* Piperazines / therapeutic use* Pyrimidines / therapeutic use* RNA, Messenger / genetics Remission Induction Reverse Transcriptase Polymerase Chain Reaction Sensitivity and Specificity Stem Cell Transplantation* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/Fusion Proteins, bcr-abl; 0/Piperazines; 0/Pyrimidines; 0/RNA, Messenger; 152459-95-5/imatinib |
| Comments/Corrections | |
Comment In:
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Blood. 2010 Aug 26;116(8):1192
[PMID:
20798240
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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