Good correlation between RT-PCR analysis and relapse in Philadelphia (Ph1)-positive acute lymphoblastic leukemia (ALL)
Good correlation between RT-PCR analysis and relapse in Philadelphia (Ph1)-positive acute lymphoblastic leukemia (ALL)
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DOI：
10.1038/sj.leu.2400567
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发表时间：
1997-02
期刊：
影响因子：
11.4
通讯作者：
C. Preudhomme;N. Henic;B. Cazin;J. Laï;M. Berthéas;M. Vanrumbeke;F. Lemoine;J. Jouet;E. Deconninck;B. Nelken;A. Cosson;P. Fenaux
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文献类型：
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作者：
C. Preudhomme;N. Henic;B. Cazin;J. Laï;M. Berthéas;M. Vanrumbeke;F. Lemoine;J. Jouet;E. Deconninck;B. Nelken;A. Cosson;P. Fenaux
我们对17例经强化化疗（CT）达到血液学完全缓解（CR）的Ph 1阳性ALL患者进行了细胞遗传学分析和BCR-ABL转录本的RT-PCR分析。对16例病例进行了前瞻性研究。除1例患者外，所有患者均达到细胞遗传学CR，但细胞遗传学在预测复发方面的敏感性较低。12例患者复发，3例在首次CR时死亡，2例在首次CR时存活。分别接受同种异体移植（第一次或第二次CR）、自体移植和接受巩固CT的5/5、2/4和5/9例患者在骨髓（BM）中实现了两轮PCR阴性：3例在CR中死亡，3例在BM中保持CR，两步PCR阴性，3例在22至28个月后复发。在所有情况下，复发之前，转换为PCR阳性的BM 4至6个月。其余9名患者在BM中保持PCR阳性，并在2至16个月后复发。在4例自体移植病例中，PCR在骨髓收获时呈阳性。接受净化移植的两名患者实现了阴性PCR和延长的CR，而接受未净化移植的两名患者保持PCR阳性并复发。在34%的样本中，分析是伴随的，PCR的灵敏度证明在血液中低于BM。这些结果表明，RT-PCR是一个有用的工具，在监测MRD的Ph 1阳性ALL。
We sequentially performed cytogenetic analysis and RT-PCR analysis of BCR-ABL transcripts in 17 cases of Ph1-positive ALL who had achieved hematological complete remission (CR) with intensive chemotherapy (CT). Sixteen cases were studied prospectively. All but one of the patients had reached cytogenetic CR, but cytogenetic has low sensitivity in predicting relapse. Twelve patients relapsed, three died in first CR and two were alive in first CR. Two of five, two of four, and five of nine patients who were allografted (in first or second CR), autografted and received consolidation CT, respectively, achieved negative two-round PCR in the bone marrow (BM): three died in CR, three remained in CR with negative two-step PCR in the BM and three relapsed after 22 to 28 months. In all cases, relapse was preceded by switch to PCR positivity in the BM by 4 to 6 months. The remaining nine patients remained PCR-positive in the BM and relapsed after 2 to 16 months. In the four autografted cases, PCR was positive at the time of bone marrow harvest. The two patients who received a purged transplant achieved negative PCR and prolonged CR, whereas the two patients who received an unpurged transplant remained PCR positive and relapsed. In 34% of the samples where analysis was concomitant, sensitivity of PCR proved lower in the blood than in the BM. These findings show that RT-PCR is a useful tool in the monitoring of MRD in Ph1 positive ALL.