Document Detail

Serial measurement of BCR-ABL transcripts in the peripheral blood after allogeneic stem cell transplantation for chronic myeloid leukemia: an attempt to define patients who may not require further therapy.
MedLine Citation:
PMID:  16449534     Owner:  NLM     Status:  MEDLINE    
We identified 243 patients with Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) who had BCR-ABL transcripts monitored by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) after allogeneic stem cell transplantation for a median of 84.3 months. Individual patients were regarded as having achieved molecular relapse (MR) if the BCR-ABL/ABL ratio exceeded 0.02% on 3 occasions or reached 0.05% on 2 occasions. Patients were allocated to 1 of 4 categories: (1) 36 patients were "persistently negative" or had a single low-level positive result; (2) 51 patients, "fluctuating positive, low level," had more than 1 positive result but never more than 2 consecutive positive results; (3) 27 patients, "persistently positive, low level," had persisting low levels of BCR-ABL transcripts but never more than 3 consecutive positive results; and (4) 129 patients relapsed. In 107 of these, relapse was based initially only on molecular criteria; in 72 (67.3%) patients the leukemia progressed to cytogenetic or hematologic relapse either prior to or during treatment with donor lymphocyte infusions. We conclude that the pattern of BCR-ABL transcript levels after allograft is variable; only a minority of patients with fluctuating or persistent low levels of BCR-ABL transcripts satisfied our definitions of MR, whereas the majority of patients who did so were likely to progress further.
Jaspal Kaeda; Derville O'Shea; Richard M Szydlo; Eduardo Olavarria; Francesco Dazzi; David Marin; Susan Saunders; Jamshid S Khorashad; Nicholas C P Cross; John M Goldman; Jane F Apperley
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-01-31
Journal Detail:
Title:  Blood     Volume:  107     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-04     Completed Date:  2006-06-14     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4171-6     Citation Subset:  AIM; IM    
Department of Haematology, Imperial College at Hammersmith Hospital, London, UK.
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MeSH Terms
Biological Markers / blood
Disease Progression
Fusion Proteins, bcr-abl / blood,  genetics*
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / blood,  genetics*,  therapy
Stem Cell Transplantation*
Transcription, Genetic*
Transplantation, Homologous / physiology*
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 0/Fusion Proteins, bcr-abl

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