Chimeric BCR-abl messenger RNA as a marker for minimal residual disease in
patients transplanted for Philadelphia chromosome-positive acute
lymphoblastic leukemia
GB Gehly, EM Bryant, AM Lee, PG Kidd and ED Thomas
Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
We correlated polymerase chain reaction (PCR)-detectable BCR-abl fusion
transcripts with cytogenetic status in 24 patients with acute lymphocytic
leukemia (ALL). Of 10 Philadelphia chromosome negative (Ph- ) patients,
only one was found to exhibit a BCR-abl fusion transcript. Fourteen
patients with Ph+ ALL, including eight in clinical remission, exhibited
PCR-detectable BCR-abl rearrangements. A detectable Ph chromosome was
present in only five of the eight patients in clinical remission. Of the
three cytogenetically negative, BCR-abl-positive patients, two eventually
succumbed to post-bone marrow transplantation (BMT) relapse. The third died
of early transplant complications. Serial PCR analyses were performed on
four Ph+ ALL patients in clinical remission who underwent allogeneic BMT.
One patient who was PCR negative on post-BMT days 21 and 75 became
PCR-positive on day 116 and died in relapse on day 154. One patient was
weakly positive for BCR-abl on day 23, negative on day 56, but died of
transplant complications on day 124. Two patients exhibited no post-BMT
BCR-abl rearrangements and remain well on days 279 and 371. Our findings
suggest that PCR analysis may be useful in the early identification of
relapse in patients transplanted for Ph+ ALL.
Volume 78,
Issue 2,
pp. 458-465,
07/15/1991
Copyright © 1991 by The American Society of Hematology
