Document Detail


Levels of minimal residual disease detected by quantitative molecular monitoring herald relapse in patients with multiple myeloma.
MedLine Citation:
PMID:  15136219     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES:Detection of minimal residual disease (MRD) has helped to improve the treatment of patients with leukemia. At present MRD testing in patients with multiple myeloma (MM) is not applied as a standard diagnostic or prognostic method. DESIGN AND METHODS: Immunoglobulin heavy chain (IgH) polymerase chain reaction (PCR) using patient-specific TaqMan probes together with LightCycler technology was performed to quantify minimal residual disease in MM. Relative levels of clonotypic cells were assessed as IgH/2beta-actin ratios with a sensitivity of 10(-4) to 10(-5). RESULTS: Following stem cell transplantation, a significant reduction of clonotypic cells was observed in bone marrow (BM) and peripheral blood (PB) samples of 11 patients, comparing pre-treatment values with those of best response (median: 13% to 0.09% and 0.03% to 0%, respectively). In 5 patients with ongoing clinical remission IgH/2beta-actin ratios remained stable at a low level, while in 6 patients an increase to 2% in BM and 0.4% in PB was associated with progression of the disease. In 4 of these 6 patients the increase of clonotypic cells in PB was detectable a median of 3 months (range: 0.5-6) before relapse. Furthermore, time-to-progression of patients with pre-transplantation IgH/2b-actin ratios > 0.03% in BM was significantly shorter than that of patients with lower MRD levels. INTERPRETATION AND CONCLUSIONS: MRD in patients with MM can be quantified reliably using TaqMan chemistry adapted to the LightCycler system. Residual tumor cell levels before transplantation as well as results of sequential molecular monitoring are predictive of relapse.
Authors:
Roland Fenk; Muharrem Ak; Guido Kobbe; Ulrich Steidl; Carolin Arnold; Mark Korthals; Ali Hünerlitürkoglu; Ulrich-Peter Rohr; Slawomir Kliszewski; Alf Bernhardt; Rainer Haas; Ralf Kronenwett
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Haematologica     Volume:  89     ISSN:  1592-8721     ISO Abbreviation:  Haematologica     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-11     Completed Date:  2006-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417435     Medline TA:  Haematologica     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  557-66     Citation Subset:  IM    
Affiliation:
Dept. of Hematology, Oncology and Clinical Immunology, University of Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany. fenk@med.uni-duesseldorf.de
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MeSH Terms
Descriptor/Qualifier:
Actins / blood
Adult
Aged
Bone Marrow Cells / cytology
Cell Line, Tumor
Clone Cells / cytology
DNA Probes / blood,  diagnostic use*
Female
Humans
Immunoglobulin Heavy Chains / blood
Male
Middle Aged
Multiple Myeloma / blood,  complications*
Neoplasm, Residual / complications,  diagnosis*
Polymerase Chain Reaction / methods*
Recurrence
Sensitivity and Specificity
Stem Cell Transplantation
Chemical
Reg. No./Substance:
0/Actins; 0/DNA Probes; 0/Immunoglobulin Heavy Chains

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