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Prepublished online as a Blood First Edition Paper on May 8, 2003; DOI 10.1182/blood-2003-01-0189.
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Blood, 1 September 2003, Vol. 102, No. 5, pp. 1927-1929
TRANSPLANTATION
Brief report
Molecular remission after myeloablative allogeneic stem cell transplantation predicts a better relapse-free survival in patients with multiple myeloma
Paolo Corradini,
Michele Cavo,
Henk Lokhorst,
Giovanni Martinelli,
Carolina Terragna,
Ignazio Majolino,
Pinuccia Valagussa,
Mario Boccadoro,
Diana Samson,
Andrea Bacigalupo,
Nigel Russell,
Vittorio Montefusco,
Claudia Voena, and
Gosta Gahrton, the Chronic Leukemia Working Party of the European Group for Blood and
Marrow Transplantation (EBMT)
From the Hematology–Bone Marrow Transplantation Unit, Istituto
Nazionale dei Tumori, University of Milan, Milan, Italy; the Hematology
Department, Istituto Seragnoli, University of Bologna, Bologna, Italy; the
Hematology Department, Ospedale S. Camillo, Rome, Italy; the Hematology
Department, University of Torino, Torino, Italy; the Hematology Department,
Ospedale S. Martino, Genoa, Italy; the Hematology Department, University
Medical Center, Utrecht, the Netherlands; the Hematology Department, Imperial
College School of Medicine, Hammersmith Hospital, London, United Kingdom; the
Hematology Department, Nottingham City Hospital, Nottingham, United Kingdom;
and the Hematology Department, Huddinge University Hospital, Huddinge,
Sweden.
Patients in complete clinical remission after myeloablative allogeneic stem
cell transplantation (allo-SCT) were enrolled in a longitudinal study to
assess the predictive value of molecular monitoring. Using polymerase chain
reaction (PCR) for immunoglobulin gene rearrangements it was possible to
generate a clone-specific molecular marker in 48 of 70 patients. Of these 48
patients, 16 (33%) attained durable PCR-negativity after transplantation,
whereas 13 (27%) remained persistently PCR-positive and 19 (40%) showed a
mixed pattern. The cumulative risk of relapse at 5 years was 0% for
PCR-negative patients, 33% for PCR-mixed patients, and 100% for PCR-positive
patients. Within the group studied it was not possible to identify any
clinical feature predictive of durable PCR-negativity. We believe that these
findings could prompt the design of prospective studies to evaluate if the
treatment of molecular disease can extend remission duration and survival.
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