Concurrent presence of both patient and donor t(14;18) in a follicular lymphoma patient after undergoing allogeneic BMT: implications for minimal residual disease detection post-transplant

Rosenblum, Michael D.; Drobyski, William R.; Keever-Taylor, Carolyn A.; Cc, Chang

doi:10.1038/sj.bmt.1704039

Cited by 3 publications

(2 citation statements)

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“…The recipient remains in complete remission at 145 months post transplant ( Table 4). The third case (case#573), reported previously, 17 had detectable t(14;18) of donor origin with eight serial determinations over a 5-year period (Table 4). This patient never developed FL with follow-up of 109 months.…”

Section: Resultsmentioning

confidence: 99%

“…We recently described the disappearance of a patient's t (14;18) clone early post transplant with the concomitant emergence and long-term persistence of the donor's t(14;18) clone without development of FL. 17 Although it has not been well studied, donor carrying t(14;18) clones detectable by RQ-PCR could theoretically develop into FL in an immunosuppressed recipient who may have a genetic susceptibility to develop FL. In addition, the presence of t(14;18) clones in the donor could serve as a surrogate marker of a stem cell defect and thus affect transplant outcome in some other manner.…”

Section: Pcrmentioning

confidence: 99%

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The implication of follicular lymphoma patients receiving allogeneic stem cell transplantation from donors carrying t(14;18)-positive cells

Keever-Taylor

Bredeson

et al. 2005

Bone Marrow Transplant

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Summary:We performed real-time quantitative polymerase chain reaction (RQ-PCR) in peripheral blood (PB) and/or bone marrow (BM) samples collected pre-and post transplant from 23 recipient-donor pairs receiving allogeneic stem cell transplantation (allo-SCT) for follicular lymphoma (FL). Of 23 donors, 11 had a PB and/or BM sample positive for t(14;18) (BCL2/IGH fusion) at low levels (oone t(14;18) cell in 10K total cells). Recipients from donors with (n ¼ 11) and those without (n ¼ 12) detectable t(14:18) cells were similar in age, sex, and disease status pretransplant. No differences in the incidence of graft-versus-host-disease (GVHD), delayed engraftment, relapse rate, disease-free survival and overall survival were identified between the groups. Two recipients without detectable t(14;18) cells pretransplant showed detectable t(14;18) cells at 2 and 11 years after receiving grafts from donors with t(14:18) cells. Neither patient developed FL 1.5 and 2 years after the emergence of t(14;18) cells. Although the sample size is relatively small, our findings suggest that individuals carrying t(14;18) cells may not be excluded as donors given the lack of an association of t(14;18) detected in donors with adverse clinical outcome. It may be necessary to screen for the donor's t(14;18) status before using t(14;18) for monitoring minimal residual disease by RQ-PCR to exclude the possibility of confounding donor's t (14;18) [4][5][6][7][8][9][10][11] Allogeneic stem cell transplantation (allo-SCT) is of increasing interest as a therapeutic option for patients due to the potential of a graft-versus-lymphoma effect to provide long-term disease control. [12][13][14][15] We have recently reported that monitoring the tumor load of t(14;18) cells by real-time quantitative PCR (RQ-PCR) may predict the outcome of FL patients after allo-SCT. 16 Patients with tumor loads of greater than one t(14;18) cell per 10K total cells post transplantation have a higher risk of clinical relapse than those without. The monitoring of minimal residual disease (MRD) by RQ-PCR allows for the development of strategies, such as donor lymphocyte infusions to be employed at a stage of molecular relapse in patients whose RQ-PCR results suggest a high likelihood of subsequent clinical relapse.The utility of using RQ-PCR to monitor tumor load or MRD after allo-SCT, however, can be confounded by the presence of t(14;18) cells of donor origin. We recently described the disappearance of a patient's t(14;18) clone early post transplant with the concomitant emergence and long-term persistence of the donor's t(14;18) clone without development of FL. 17 Although it has not been well studied, donor carrying t(14;18) clones detectable by RQ-PCR could theoretically develop into FL in an immunosuppressed recipient who may have a genetic susceptibility to develop FL. In addition, the presence of t(14;18) clones in the donor could serve as a surrogate marker of a stem cell defect and thus affect transplant outcome in some other manner. Thus, the aims of the current ...

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Section: Resultsmentioning

confidence: 99%

Section: Pcrmentioning

confidence: 99%