Paper
Bone Marrow Transplantation (2005) 35, S49–S52. doi:10.1038/sj.bmt.1704847
Is there a role for minimal residual disease levels in the treatment of ALL patients who receive allogeneic stem cells?
M W Schilham1, A Balduzzi2 and P Bader3 on behalf of the PD-WP of the EBMT
- 1Department of Pediatrics, Leiden University Medical Center, Leiden, NL, The Netherlands
- 2Clinica Pediatrica Università degli Studi di Milano Bicocca, Monza, IT
- 3University Children's Hospital, Tübingen, GE
Correspondence: Dr MW Schilham, Department of Pediatrics, Leiden University Medical Center, Leiden, NL, The Netherlands. E-mail: M.W.Schilham@LUMC.nl
Abstract
Relapse is the major complication after allogeneic stem cell transplantation (SCT) for acute lymphoblastic leukemia (ALL) in children. Since it has been possible to measure minimal residual disease (MRD) by real-time quantitative polymerase chain reaction, this parameter is used more frequently in the treatment of ALL. In this article, the role of MRD and chimerism in the treatment and monitoring of pediatric transplantation recipients is described. Pre-SCT MRD levels can predict the risk of relapse and can thus be used to adjust treatment. Post-SCT MRD levels and changes in chimerism can predict relapses as well, although not many treatment options are available today, except relying on a graft-versus-leukemia effect mediated by graft-versus-host disease. Finding new treatments will be the challenge for the near future.
Keywords:
minimal residual disease, MRD, acute lymphoblastic leukemia, ALL, stem cell transplantation, SCT, allogeneic
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