Minimal residual leukemia in autologous peripheral blood stem cell transplantation

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We investigated minimal residual disease (MRD) in autologous peripheral blood stem cell transplantation (PBSCT) for acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) in children. MRD can be defined as disease occurring at a subclinical level and beyond detection by conventional methods of assessment. Application of the polymerase chain reaction (PCR) to the hypervariable segment of the immunoglobulin heavy chain (IgH) gene or T-lymphocyte receptor gene and RT-PCR of specific chimera messenger RNA,allows detection of MRD in ALL and AML at a level of one leukemic cell in 10^4-10^5 normal marrow cells. The detection of MRD of harvested peripheral blood stem cell (PBSC) have a value in the indication of autologous PBSCT.We detected MRD in the harvested PBSC after complete remission for 3 cases of ALL and 4 cases of AML.In a case of AML with t(8 ; 21)(q22 ; q22), chimeric RNA was detected in PBSC.In other cases, MRD was not detected in PBSC.These 7 patients with acute leukemia were performed autologous PBSCT.Six patients have sustained complete remission without sign of MRD after transplantation. But in a case of AML with t(8 ; 21)(q22 ; q22) who has chimeric RNA in her PBSC,bone marrow relapse occurred 6 month after transplantation.