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Minimal Residual Disease

Allogeneic bone marrow transplantation (BMT) for adults with acute lymphoblastic leukemia (ALL): predictive role of minimal residual disease monitoring on relapse

Bone Marrow Transplantation volume 30, pages 579–585 (2002)Cite this article

Abstract

We developed a PCR-based method to monitor clonogenic IgH VDJ rearrangement as a possible predictor of relapse in patients with acute B-ALL after allogeneic bone marrow transplantation (BMT). We studied 23 patients at diagnosis, before and after BMT. At the time of BMT, 13 patients were in first complete remission, eight in second complete remission and two in relapse. Four patients were PCR negative before BMT and remained PCR negative also after BMT (−/− pattern). They are still in remission after a median follow-up of 41 months. Nineteen patients were MRD-positive before BMT: three were PCR negative at first determination after BMT (+/− pattern) and maintain remission. Sixteen patients were PCR-positive at first determination after BMT (+/+ pattern): five became PCR negative (+/+/− pattern) (four with chronic graft-versus-host disease (GVHD) and two after donor lymphocyte infusions (DLI)). Nine patients remained PCR-positive (+/+/+ pattern) (four remain in remission, and six relapsed); two patients died before transplant. In conclusion, PCR negative patients before BMT remained negative post-BMT; many pre-BMT positive patients had initial MRD positivity after BMT: 37% of them achieved a molecular remission with cGVHD or DLI.

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Acknowledgements

This work was supported in part by grants from AIRC (Associazione Italiana per la Ricerca sul Cancro), CNR (grant 9502285) and MURST; work performed according to CNR and MIUR program Law 449/97–98.

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Authors and Affiliations

  1. Department of Internal Medicine (DIMI), Università degli Studi di Genova, Italy

    M Miglino, R Grasso, L Canepa, M Clavio, I Pierri, D Pietrasanta, S Gatto, R Varaldo, F Ballerini, M Sessarego & M Gobbi

  2. Department of Haematology and Oncology, Azienda Ospedale S Martino e Cliniche Universitarie Convenzionate, Genova, Italy

    M Miglino, G Berisso, R Grasso, L Canepa, M Clavio, I Pierri, D Pietrasanta, S Gatto, R Varaldo, F Ballerini, M Sessarego, A Dominietto, AM Raiola, S Bregante, C di Grazia, M Gobbi & A Bacigalupo

  3. Department of Legal Medicine (DIMEL), Università degli Studi di Genova, Italy

    S Verdiani, L Casarino & F DeStefano

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  1. M Miglino
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  2. G Berisso
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  14. M Sessarego
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  19. M Gobbi
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Miglino, M., Berisso, G., Grasso, R. et al. Allogeneic bone marrow transplantation (BMT) for adults with acute lymphoblastic leukemia (ALL): predictive role of minimal residual disease monitoring on relapse. Bone Marrow Transplant 30, 579–585 (2002). https://doi.org/10.1038/sj.bmt.1703659

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