Preemptive treatment of minimal residual disease post transplant in CML using real-time quantitative RT-PCR: a prospective, randomized trial

Kim, Yoon Jun; Dw, Kim; S, Lee; Ng, Chung; Jy, Hwang; Yl, Kim; Ck, Min; Cc, Kim

doi:10.1038/sj.bmt.1704386

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…Based on our data, >8 patients should be treated to prevent 1 relapse. Many different therapies (donor lymphocytes infusion, TKIs, immunosuppressant withdrawal) may be used to obtain a complete remission or to maintain low-level BCR-ABL transcript levels in patients at risk of relapse [37,38]. The role of immunotherapy and imatinib (or other TKIs) in obtaining a molecular or cytogenetic response in relapsed patients still needs to be better defined [39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Molecular Monitoring of BCR-ABL Transcripts after Allogeneic Stem Cell Transplantation for Chronic Myeloid Leukemia

Arpinati

Tolomelli

Bochicchio

et al. 2013

Biology of Blood and Marrow Transplantation

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The monitoring of minimal residual disease (MRD) through low sensitivity real-time (RT) polymerase chain reaction (PCR) analysis of BCR-ABL transcripts allows early detection of chronic myeloid leukemia (CML) relapse after allogeneic hematopoietic stem cell transplantation (HSCT). The introduction of more sensitive techniques, such as RT quantitative (Q)-PCR, may lead to an overestimation of the risk of CML relapse. In this study, we reviewed the results of peripheral blood RT Q-PCR in CML patients who underwent allogeneic HSCT from 1983 to 2007. In our laboratory, RT Q-PCR analysis was routinely performed since 2002. Eighty-seven of 189 patients had available RT Q-PCR data; 63 patients had at least 3 RT Q-PCR analyses assessable. Fifty-two of 63 patients (83%) had, at least once, detectable transcript levels, but with an BCR-ABL/ABL ratio <.1% defined as .1% confirmed by the finding of Ph+ cells in bone marrow. No patients with persistent undetectable transcripts relapsed (P = .19). Relapse did not correlate with the number of occurrences of

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Section: Discussionmentioning

confidence: 99%

Molecular Monitoring of BCR-ABL Transcripts after Allogeneic Stem Cell Transplantation for Chronic Myeloid Leukemia

Arpinati

Tolomelli

Bochicchio

et al. 2013

Biology of Blood and Marrow Transplantation

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“…As the MRD level in the pre-NST imatinib group at transplant was significantly lower than that of the no imatinib group (P ¼ 0.0001), and only one patient (10%) in the pre-NST imatinib group demonstrated a high level of normalized BCR-ABL transcripts X0.01 at 3 months post-transplant, compared to 44% (four out of nine) in the no imatinib group, we can speculate that a low MRD level induced by imatinib may contribute to the full development of the GVL effects. In our previous observations, 7 all patients with a normalized BCR-ABL X0.01 eventually progressed to cytogenetic relapse without pre-emptive immunotherapy.…”

Section: To the Editormentioning

confidence: 99%

“…The median time to the last follow-up was 18 and 20 months in pre-NST imatinib and in the no imatinib group, respectively. Using conventional cytogenetics, nested reverse transcriptase polymerase chain reaction (RT-PCR), and quantitative real time RT-PCR (Q-RT-PCR) assays, as previously described, 7 MRD was assessed from bone marrow samples in all cases at diagnosis, immediately before the transplant, and every 3 months after the transplant. The MRD was assessed more frequently at 1-2-month intervals when needed.…”

Section: To the Editormentioning

confidence: 99%

Pretransplant imatinib can improve the outcome of nonmyeloablative stem cell transplantation without increasing the morbidity in Philadelphia chromosome-positive chronic myeloid leukemia

Chung

Lee

et al. 2004

Leukemia

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“…15,16 Third, MRD testing can be applied to stem cell products that are to be used for autologous transplantation, to ensure that the reinfused material is free of contaminating tumor. 17 Finally, in addition to the above three contexts in which MRD testing exploits the sensitivity of testing, the specificity of ARGR can also be a valuable phenomenon.…”

Section: Clinical Indications For Analyzing Immunoglobulin Gene Rearrmentioning

confidence: 99%

Malleable Immunoglobulin Genes and Hematopathology – The Good, the Bad, and the Ugly

Bagg

2008

The Journal of Molecular Diagnostics

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Immunoglobulin gene rearrangement analysis is one of the more commonly performed assays available on the hematopathology menu of clinical molecular pathology laboratories. The analysis of these rearrangements provides useful information on a number of different levels in the evaluation of lymphoproliferations. An appreciation of the various mechanisms involved in the numerous physiological pathways affecting the immunoglobulin genes , and hence antibody molecules, is central to an understanding of B-cell development vis-à-vis the generation of immunological diversity. Knowledge about the intricate complexities of these mechanisms is also germane to an evaluation of testing methodologies. With this information, it is easier to develop an understanding of how contemporary molecular testing of immunoglobulin gene rearrangements has evolved, from historically quite heterogeneous, fairly flawed, and rather ugly approaches to current more-standardized protocols. In addition, recognition of how such genetic changes with good intentions can turn bad has fostered increasing insights into the pathogenesis of B-cell lymphomas and leukemias. Despite the significant improvements in the design of immunoglobulin gene rearrangement assays, numerous pitfalls and caveats remain. Accordingly, it is crucial to consider such testing a tool , and although most useful , it is one of many tools that may be required to build cogent diagnoses. (J Mol Diagn

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Preemptive treatment of minimal residual disease post transplant in CML using real-time quantitative RT-PCR: a prospective, randomized trial

Cited by 9 publications

References 24 publications

Molecular Monitoring of BCR-ABL Transcripts after Allogeneic Stem Cell Transplantation for Chronic Myeloid Leukemia

Molecular Monitoring of BCR-ABL Transcripts after Allogeneic Stem Cell Transplantation for Chronic Myeloid Leukemia

Pretransplant imatinib can improve the outcome of nonmyeloablative stem cell transplantation without increasing the morbidity in Philadelphia chromosome-positive chronic myeloid leukemia

Malleable Immunoglobulin Genes and Hematopathology – The Good, the Bad, and the Ugly

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