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All advanced stage non-Hodgkin's lymphomas with a polymerase chain reaction
amplifiable breakpoint of bcl-2 have residual cells containing the bcl-2
rearrangement at evaluation and after treatment
JG Gribben, As Freedman, SD Woo, K Blake, RS Shu, G Freeman, JA Longtine, GS Pinkus and LM Nadler
Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA
02115.
Polymerase chain reaction (PCR) of bcl-2 provides an extremely sensitive
method to detect minimal disease in approximately 50% of patients with
non-Hodgkin's lymphomas (NHL). In an attempt to determine the clinical
usefulness of this technique, we examined the bone marrow (BM) of 152
patients with advanced-stage NHL at the time of evaluation and after
induction or salvage chemotherapy before autologous BM transplantation. The
BM proved to be an accessible and reproducible tissue source to determine
PCR positivity because all of the 102 patients examined had the same
PCR-amplifiable breakpoint in their BM and lymph node. At the time of
evaluation, PCR analysis in advanced- stage NHL patients added little
additional information to morphologic analysis because each technique
identified BM infiltration in approximately 70% of patients. PCR was
significantly more useful in determining BM infiltration after induction or
salvage therapy. At that time, approximately 50% of patients had
morphologically normal BM, whereas PCR analysis remained positive in 100%
of those with an amplifiable breakpoint. These observations were confirmed
in a clinical trial attempting to induce remission in previously untreated
low-grade advanced-stage NHL patients. In this series, PCR was positive in
all patients after treatment although the BM was histologically uninvolved
in 50% of cases, showing that conventional therapy did not eradicate
bcl-2-positive cells.
Volume 78,
Issue 12,
pp. 3275-3280,
12/15/1991
Copyright © 1991 by The American Society of Hematology

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