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Chronic Myeloproliferative Disorders

Prediction of relapse by day 100 BCR-ABL quantification after allogeneic stem cell transplantation for chronic myeloid leukemia

Leukemia volume 20, pages 793–799 (2006)Cite this article

Abstract

Chronic myeloid leukemia (CML) relapse after allogeneic stem cell transplantation (SCT) is a relatively frequent situation, which is correlated to disease status, time from diagnosis to transplant and T-cell depletion. We evaluated the potential for early minimal residual disease (MRD) BCR-ABL quantification to predict relapse of CML patients receiving allogeneic SCT. Minimal residual disease was analyzed by real-time quantitative reverse transcriptase-polymerase chain reaction (RQ-PCR) at day 100 (d100) in 38 patients with >1 year follow-up after conventional non-T-cell-depleted SCT. Normal ABL control values from 1724 follow-up blood samples were used to define an RQ-PCR amplifiability index and the limits of reliable use of BCR-ABL ratios. We then compared the 14 patients with a high-level d100 BCR-ABL/ABL ratio (⩾10−4) to that of the 24 patients with a negative/low-level ratio (<10−4). Despite being comparable for all classical parameters, the incidence of relapse was significantly higher in the high MRD group (11/14 (79%)) compared to that of the low/negative MRD group (7/24 (29%)) (P=0.009), with d100 MRD values representing an independent risk factor of relapse and disease-free survival, but not of overall survival, in multivariate analysis. These data should facilitate risk-adapted post-transplant immunosuppression and/or tyrosine kinase inhibitor therapy based on an early evaluation of MRD.

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Acknowledgements

This work was supported by the ‘Fondation contre la leucémie de la Fondation de France’, the ‘Ligue Nationale Contre le Cancer’ and the ‘Association de la Recherche sur le Cancer (ARC)’.

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Author notes

  1. V Asnafi and M-T Rubio: These authors contributed equally to this work.

Authors and Affiliations

  1. Laboratoire d'Hématologie, AP-HP Necker, Paris, France

    V Asnafi, E Delabesse & E Macintyre

  2. INSERM EMI02.10, AP-HP Necker, Paris, France

    V Asnafi, E Delabesse & E Macintyre

  3. Service d'Hématologie Adultes, AP-HP Necker, Paris, France

    M-T Rubio, I Hirsch, B Varet & A Buzyn

  4. Service de Néphrologie and Laboratoire de Biostatistiques, Centre Hospitalier Lyon-Sud, Lyon, France

    E Villar

  5. Laboratoire d'Hématologie, AP-HP La Pitié-Salpétrière, Paris, France

    F Davi

  6. Service d'Oncologie et Hématologie, Hôpital d'Amiens, Paris, France

    G Damaj

  7. Service d'Hématologie, AP-HP La Pitié-Salpétrière, Paris, France

    N Dhédin & J P Vernant

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Correspondence to E Macintyre.

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Asnafi, V., Rubio, MT., Delabesse, E. et al. Prediction of relapse by day 100 BCR-ABL quantification after allogeneic stem cell transplantation for chronic myeloid leukemia. Leukemia 20, 793–799 (2006). https://doi.org/10.1038/sj.leu.2404170

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  • DOI: https://doi.org/10.1038/sj.leu.2404170

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