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Minimal Residual Disease

PCR detection of residual Bcl-2/IgH-positive cells after high-dose therapy with autologous stem cell transplantation is a prognostic factor for event-free survival in patients with low-grade follicular non-Hodgkin's lymphoma

Bone Marrow Transplantation volume 31, pages 467–473 (2003)Cite this article

Summary:

This study was designed to evaluate the results of high-dose therapy followed by purged autologous stem cell transplantation (ASCT) for patients with low-grade follicular non Hodgkin's lymphoma (LGFL), and the prognostic significance of PCR detection of residual Bcl-2/IgH-positive cells after ASCT. Between 1992 and 1998, 49 patients with LGFL received total body irradiation and high-dose cyclophosphamide followed by purged ASCT. PCR amplification of the Bcl-2/IgH rearrangement was performed at diagnosis, on stem cell collections before and after purging and on bone marrow and blood samples after ASCT. With a median follow-up of 76 months (37–103) 34 patients remain alive and event-free. A total of 20 patients had disease recurrence, three patients developed secondary myelodysplastic syndrome (MDS). In all, 11 patients died; 10 deaths were because of recurrent disease, one because of MDS. Kaplan–Meier estimates of event-free survival (EFS) and overall survival (OS) at 5 years were 65% (±7%) and 77% (±6%), respectively. Patients who achieved a sustained molecular complete response (CR) had a lower risk of disease recurrence and experienced significantly longer EFS (93% (±6%) vs 11% (±7%) P=0.0008) and OS (100 vs 55% (±12%) P=0.0057). In conclusion, myeloablative therapy followed by purged ASCT may induce long EFS in patients with LGFL. The achievement of sustained molecular CR after ASCT improves EFS and OS.

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Acknowledgements

We gratefully acknowledge the excellent technical assistance of A Cassidanius, S Bercegeay, and C Even.

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  1. Service d'Hématologie, Centre Hospitalier Universitaire Nantes, France

    B Mahé, N Milpied, M P Mellerin, P Moreau, N Morineau, M Vigier & J L Harousseau

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Mahé, B., Milpied, N., Mellerin, M. et al. PCR detection of residual Bcl-2/IgH-positive cells after high-dose therapy with autologous stem cell transplantation is a prognostic factor for event-free survival in patients with low-grade follicular non-Hodgkin's lymphoma. Bone Marrow Transplant 31, 467–473 (2003). https://doi.org/10.1038/sj.bmt.1703829

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