Pretransplantation burden of leukemic progenitor cells as a predictor of relapse after bone marrow transplantation for acute lymphoblastic leukemia.
Pretransplantation burden of leukemic progenitor cells as a predictor of relapse after bone marrow transplantation for acute lymphoblastic leukemia.
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白血病祖细胞的移植前负担作为急性淋巴细胞白血病骨髓移植后复发的预测因子。
DOI：
10.1056/nejm199310283291802
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Ramsay,NK
中科院分区：
文献类型：
--
作者：
Uckun,FM;Kersey,JH;Haake,R;Weisdorf,D;Nesbit,ME;Ramsay,NK
背景我们开发了一种检测急性淋巴细胞白血病（ALL）缓解期患者骨髓中少量残留白血病祖细胞的方法。初步研究表明，在接受骨髓移植之前，这些患者的白血病祖细胞负荷不同。这些观察表明，这些细胞的负担可能会影响复发的风险transplant.MethodsThe骨髓移植前的残留白血病祖细胞的数量测定83例高危ALL患者。我们将多参数流式细胞术和细胞分选与白血病祖细胞检测相结合，采用定量方法检测微小残留病。结果缓解期患者骨髓标本中白血病祖细胞计数在患者之间差异显著，范围为0至12，546个细胞/百万单核细胞，或0至1.255（中位数，每百万个单核细胞51个白血病祖细胞，或0.005%）。白血病祖细胞计数超过中位数的患者比低于中位数的患者复发的可能性更高（一年复发率，100%对41%; P<0.001）。移植前骨髓造血祖细胞含量与移植后缓解时间呈显著负相关（P<0.001）。估计复发的风险为患者≥ 51白血病祖细胞每百万单核细胞的患者是3.5倍以上的风险较低的计数，调整后的影响，其他协变量（P = 0.005）。其测量可能有助于分析和改善高危ALL缓解期患者的治疗。
BackgroundWe developed a test to discern small numbers of residual leukemic progenitor cells in the bone marrow of patients with acute lymphoblastic leukemia (ALL) in remission. Preliminary studies revealed that before undergoing bone marrow transplantation such patients differed in their burden of leukemic progenitor cells. These observations suggested that the burden of these cells might influence the risk of relapse after transplantation.MethodsThe number of residual leukemic progenitor cells before bone marrow transplantation was determined for 83 patients with high-risk ALL. We combined multiparameter flow cytometry and cell sorting with assays for leukemic progenitor cells in a quantitative method for the detection of minimal residual disease.ResultsThe count of leukemic progenitor cells in bone marrow specimens from patients in remission varied markedly between patients, ranging from 0 to 12,546 cells per million mononuclear cells, or from 0 to 1.255 percent (median, 51 leukemic progenitor cells per million mononuclear cells, or 0.005 percent). Patients whose count of leukemic progenitor cells exceeded the median value had a higher likelihood of relapse than did patients with values below the median (relapse rate at one year, 100 percent vs. 41 percent; P<0.001). There was a statistically significant inverse relation between the leukemic progenitor-cell content of bone marrow before transplantation and the duration of remission after transplantation (P<0.001). The estimated risk of relapse for patients with ≥ 51 leukemic progenitor cells per million mononuclear cells was more than 3.5 times the risk for patients with lower counts, after adjustment for the effects of other covariates (P = 0.005).ConclusionsThe count of residual leukemic progenitor cells is a powerful predictor of relapse after autologous bone marrow transplantation, particularly among male patients. Its measurement may be useful for analyzing and improving the treatment of patients with high-risk ALL in remission.
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隐匿性克隆性白血病药物敏感性与自体骨髓移植后复发的相关性。
影响因子：
20.3
作者：
Miller,CB;Zehnbauer,BA;Piantadosi,S;Rowley,SD;Jones,RJ
通讯作者：
Jones,RJ
影响因子：
20.3
作者：
Richard E. Champlin;R. Gale
通讯作者：
Richard E. Champlin;R. Gale
使用聚合酶链反应检测微小残留恶性疾病[编辑]
影响因子：
20.3
作者：
R. Negrin;K. Blume
通讯作者：
K. Blume
检测缓解期间获得的骨髓培养物中残留的急性淋巴细胞白血病细胞。
DOI：
10.1056/nejm198608283150902
发表时间：
1986
期刊：
The New England journal of medicine
影响因子：
--
作者：
Z. Estrov;T. Grunberger;I. Dubé;Y. P. Wang;M. Freedman
通讯作者：
M. Freedman
使用免疫毒素加 4-氢过氧环磷酰胺进行骨髓净化，对高危缓解型 T 系急性淋巴细胞白血病进行自体骨髓移植。
影响因子：
20.3
作者：
Uckun,FM;Kersey,JH;Vallera,DA;Ledbetter,JA;Weisdorf,D;Myers,DE;Haake,R;Ramsay,NK
通讯作者：
Ramsay,NK