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Blood, Vol. 95 No. 2 (January 15), 2000:
pp. 404-408
Persistence of BCR-ABL genomic rearrangement in chronic myeloid
leukemia patients in complete and sustained cytogenetic remission after
interferon- therapy or allogeneic bone marrow transplantation
Jean-Claude Chomel,
Françoise Brizard,
Anne Veinstein,
Jérôme Rivet,
Alain Sadoun,
Alain Kitzis,
François Guilhot, and
André Brizard
From the Laboratoire de Génétique Cellulaire et
Moléculaire (UPRES EA 2622), the Laboratoire d'Hématologie
(CNRS ESA 6031), and the Département d'Hématologie et
Oncologie Médicale (UPRES EA 2622), CHU de Poitiers, France.
In recent years, the prognosis of chronic myeloid leukemia (CML) has
been greatly improved either with interferon- (IFN-) therapy or
allogeneic bone marrow transplantation (BMT). In the present study,
minimal residual disease was evaluated in 21 patients in complete
cytogenetic response (CCR) after such treatments. Samples from bone
marrow aspirates or peripheral blood or both were analyzed by
conventional cytogenetics, Southern blot, interphase fluorescent in
situ hybridization (FISH), and quantitative reverse transcription-polymerase chain reaction (Q-RT-PCR). In all patients, FISH detected 1% to 12% nuclei with a BCR-ABL fusion gene, whereas Q-RT-PCR experiments were negative or weakly positive. Based on these
results, we hypothesize that the BCR-ABL genomic rearrangement persists
unexpressed in nonproliferating cells whatever the treatment (IFN-
or BMT). These data point to the need for follow-up of CML patients in
CCR over an extensive period at the DNA level (FISH) to evaluate the
residual disease and at the RNA level (Q-RT-PCR) to estimate the risk
of relapse.
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