SEARCH:   Advanced

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Rawstron, A. C. Articles by Hillmen, P. Search for Related Content PubMed PubMed Citation Articles by Rawstron, A. C. Articles by Hillmen, P. Related Collections Clinical Trials and Observations Neoplasia Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 July 2001, Vol. 98, No. 1, pp. 29-35 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Quantitation of minimal disease levels in chronic lymphocytic leukemia using a sensitive flow cytometric assay improves the prediction of outcome and can be used to optimize therapy Andy C. Rawstron, Ben Kennedy, Paul A. S. Evans, Faith E. Davies, Stephen J. Richards, Andy P. Haynes, Nigel H. Russell, Geoff Hale, Gareth J. Morgan, Andrew S. Jack, and Peter Hillmen From Haematological Malignancy Diagnostic Service, Leeds General Infirmary, Leeds, United Kingdom; Nottingham City Hospital, Nottingham, United Kingdom; and the Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom. Previous studies have suggested that the level of residual disease at the end of therapy predicts outcome in chronic lymphocytic leukemia (CLL). However, available methods for detecting CLL cells are either insensitive or not routinely applicable. A flow cytometric assay was developed that can differentiate CLL cells from normal B cells on the basis of their CD19/CD5/CD20/CD79b expression. The assay is rapid and can detect one CLL cell in 104 to 105 leukocytes in all patients. We have compared this assay to conventional assessment in 104 patients treated with CAMPATH-1H and/or autologous transplant. During CAMPATH-1H therapy, circulating CLL cells were rapidly depleted in responding patients, but remained detectable in nonresponders. Patients with more than 0.01 × 109/L circulating CLL cells always had significant (> 5%) marrow disease, and blood monitoring could be used to time marrow assessments. In 25 out of 104 patients achieving complete remission by National Cancer Institute (NCI) criteria, the detection of residual bone marrow disease at more than 0.05% of leukocytes in 6 out of 25 patients predicted significantly poorer event-free (P = .0001) and overall survival (P = .007). CLL cells are detectable at a median of 15.8 months (range, 5.5-41.8) posttreatment in 9 out of 18 evaluable patients with less than 0.05% CLL cells at end of treatment. All patients with detectable disease have progressively increasing disease levels on follow-up. The use of sensitive techniques, such as the flow assay described here, allow accurate quantitation of disease levels and provide an accurate method for guiding therapy and predicting outcome. These results suggest that the eradication of detectable disease may lead to improved survival and should be tested in future studies. © 2001 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letter in Blood Online: Different clinical value of minimal residual disease after autologous and allogeneic stem cell transplantation for chronic lymphocytic leukemia Jordi Esteve, Neus Villamor, Dolors Colomer, Emili Montserrat, Andy C. Rawstron, and Peter Hillmen Blood 2002 99: 1873-1874. [Full Text] [PDF] This article has been cited by other articles: S. Bottcher, M. Ritgen, S. Buske, S. Gesk, W. Klapper, E. Hoster, W. Hiddemann, M. Unterhalt, M. Dreyling, R. Siebert, et al. Minimal residual disease detection in mantle cell lymphoma: methods and significance of four-color flow cytometry compared to consensus IGH-polymerase chain reaction at initial staging and for follow-up examinations Haematologica, April 1, 2008; 93(4): 551 - 559. [Abstract] [Full Text] [PDF] S. Mittal, M. G. Blaylock, D. J. Culligan, R. N. Barker, and M. A. Vickers A high rate of CLL phenotype lymphocytes in autoimmune hemolytic anemia and immune thrombocytopenic purpura Haematologica, January 1, 2008; 93(1): 151 - 152. [Abstract] [Full Text] [PDF] F. Bosch, A. Ferrer, N. Villamor, M. Gonzalez, J. Briones, E. Gonzalez-Barca, E. Abella, S. Gardella, L. Escoda, E. Perez-Ceballos, et al. Fludarabine, Cyclophosphamide, and Mitoxantrone as Initial Therapy of Chronic Lymphocytic Leukemia: High Response Rate and Disease Eradication Clin. Cancer Res., January 1, 2008; 14(1): 155 - 161. [Abstract] [Full Text] [PDF] S. Willimott, M. Baou, S. Huf, S. Deaglio, and S. D. Wagner Regulation of CD38 in proliferating chronic lymphocytic leukemia cells stimulated with CD154 and interleukin-4 Haematologica, October 1, 2007; 92(10): 1359 - 1366. [Abstract] [Full Text] [PDF] T. Robak, J. Z. Blonski, J. Gora-Tybor, K. Jamroziak, J. Dwilewicz-Trojaczek, A. Tomaszewska, L. Konopka, B. Ceglarek, A. Dmoszynska, M. Kowal, et al. Cladribine alone and in combination with cyclophosphamide or cyclophosphamide plus mitoxantrone in the treatment of progressive chronic lymphocytic leukemia: report of a prospective, multicenter, randomized trial of the Polish Adult Leukemia Group (PALG CLL2) Blood, July 15, 2006; 108(2): 473 - 479. [Abstract] [Full Text] [PDF] C. Moreno, N. Villamor, D. Colomer, J. Esteve, E. Gine, A. Muntanola, E. Campo, F. Bosch, and E. Montserrat Clinical significance of minimal residual disease, as assessed by different techniques, after stem cell transplantation for chronic lymphocytic leukemia Blood, June 1, 2006; 107(11): 4563 - 4569. [Abstract] [Full Text] [PDF] J. G. Gribben, D. Zahrieh, K. Stephans, L. Bartlett-Pandite, E. P. Alyea, D. C. Fisher, A. S. Freedman, P. Mauch, R. Schlossman, L. V. Sequist, et al. Autologous and allogeneic stem cell transplantations for poor-risk chronic lymphocytic leukemia Blood, December 15, 2005; 106(13): 4389 - 4396. [Abstract] [Full Text] [PDF] D. Caballero, J. A. Garcia-Marco, R. Martino, V. Mateos, J. M. Ribera, J. Sarra, A. Leon, G. Sanz, J. de la Serna, R. Cabrera, et al. Allogeneic Transplant with Reduced Intensity Conditioning Regimens may Overcome the Poor Prognosis of B-Cell Chronic Lymphocytic Leukemia with Unmutated Immunoglobulin Variable Heavy-Chain Gene and Chromosomal Abnormalities (11q- and 17p-) Clin. Cancer Res., November 1, 2005; 11(21): 7757 - 7763. [Abstract] [Full Text] [PDF] T. Elter, P. Borchmann, H. Schulz, M. Reiser, S. Trelle, R. Schnell, M. Jensen, P. Staib, T. Schinkothe, H. Stutzer, et al. Fludarabine in Combination With Alemtuzumab Is Effective and Feasible in Patients With Relapsed or Refractory B-Cell Chronic Lymphocytic Leukemia: Results of a Phase II Trial J. Clin. Oncol., October 1, 2005; 23(28): 7024 - 7031. [Abstract] [Full Text] [PDF] T. S. Lin, M. R. Grever, and J. C. Byrd Changing the Way We Think About Chronic Lymphocytic Leukemia J. Clin. Oncol., June 20, 2005; 23(18): 4009 - 4012. [Full Text] [PDF] M. J. Keating, S. O'Brien, M. Albitar, S. Lerner, W. Plunkett, F. Giles, M. Andreeff, J. Cortes, S. Faderl, D. Thomas, et al. Early Results of a Chemoimmunotherapy Regimen of Fludarabine, Cyclophosphamide, and Rituximab As Initial Therapy for Chronic Lymphocytic Leukemia J. Clin. Oncol., June 20, 2005; 23(18): 4079 - 4088. [Abstract] [Full Text] [PDF] E. Montserrat Treatment of Chronic Lymphocytic Leukemia: Achieving Minimal Residual Disease-Negative Status As a Goal J. Clin. Oncol., May 1, 2005; 23(13): 2884 - 2885. [Full Text] [PDF] P. Moreton, B. Kennedy, G. Lucas, M. Leach, S. M.B. Rassam, A. Haynes, J. Tighe, D. Oscier, C. Fegan, A. Rawstron, et al. Eradication of Minimal Residual Disease in B-Cell Chronic Lymphocytic Leukemia After Alemtuzumab Therapy Is Associated With Prolonged Survival J. Clin. Oncol., May 1, 2005; 23(13): 2971 - 2979. [Abstract] [Full Text] [PDF] G. Hale, P. Rebello, L. R. Brettman, C. Fegan, B. Kennedy, E. Kimby, M. Leach, J. Lundin, H. Mellstedt, P. Moreton, et al. Blood concentrations of alemtuzumab and antiglobulin responses in patients with chronic lymphocytic leukemia following intravenous or subcutaneous routes of administration Blood, August 15, 2004; 104(4): 948 - 955. [Abstract] [Full Text] [PDF] A. C. Rawstron, B. Kennedy, P. Moreton, A. J. Dickinson, M. J. Cullen, S. J. Richards, A. S. Jack, and P. Hillmen Early prediction of outcome and response to alemtuzumab therapy in chronic lymphocytic leukemia Blood, March 15, 2004; 103(6): 2027 - 2031. [Abstract] [Full Text] [PDF] P. Ghia, G. Prato, C. Scielzo, S. Stella, M. Geuna, G. Guida, and F. Caligaris-Cappio Monoclonal CD5+ and CD5- B-lymphocyte expansions are frequent in the peripheral blood of the elderly Blood, March 15, 2004; 103(6): 2337 - 2342. [Abstract] [Full Text] [PDF] M. J. Keating, N. Chiorazzi, B. Messmer, R. N. Damle, S. L. Allen, K. R. Rai, M. Ferrarini, and T. J. Kipps Biology and Treatment of Chronic Lymphocytic Leukemia Hematology, January 1, 2003; 2003(1): 153 - 175. [Abstract] [Full Text] [PDF] A. C. Rawstron, F. E. Davies, R. DasGupta, A. J. Ashcroft, R. Patmore, M. T. Drayson, R. G. Owen, A. S. Jack, J. A. Child, and G. J. Morgan Flow cytometric disease monitoring in multiple myeloma: the relationship between normal and neoplastic plasma cells predicts outcome after transplantation Blood, October 16, 2002; 100(9): 3095 - 3100. [Abstract] [Full Text] [PDF] A. C. Rawstron, M. R. Yuille, J. Fuller, M. Cullen, B. Kennedy, S. J. Richards, A. S. Jack, E. Matutes, D. Catovsky, P. Hillmen, et al. Inherited predisposition to CLL is detectable as subclinical monoclonal B-lymphocyte expansion Blood, September 18, 2002; 100(7): 2289 - 2290. [Abstract] [Full Text] [PDF] A. C. Rawstron, M. J. Green, A. Kuzmicki, B. Kennedy, J. A. L. Fenton, P. A. S. Evans, S. J. M. O'Connor, S. J. Richards, G. J. Morgan, A. S. Jack, et al. Monoclonal B lymphocytes with the characteristics of "indolent" chronic lymphocytic leukemia are present in 3.5% of adults with normal blood counts Blood, June 28, 2002; 100(2): 635 - 639. [Abstract] [Full Text] [PDF] B. Kennedy, A. Rawstron, C. Carter, M. Ryan, K. Speed, G. Lucas, and P. Hillmen Campath-1H and fludarabine in combination are highly active in refractory chronic lymphocytic leukemia Blood, March 15, 2002; 99(6): 2245 - 2247. [Abstract] [Full Text] [PDF] E Matutes New additions to antibody panels in the characterisation of chronic lymphoproliferative disorders J. Clin. Pathol., March 1, 2002; 55(3): 180 - 183. [Abstract] [Full Text] [PDF] J. Esteve, N. Villamor, D. Colomer, E. Montserrat, A. C. Rawstron, and P. Hillmen Different clinical value of minimal residual disease after autologous and allogeneic stem cell transplantation for chronic lymphocytic leukemia Blood, March 1, 2002; 99(5): 1873 - 1874. [Full Text] [PDF] K. R. Rai, H. Dohner, M. J. Keating, and E. Montserrat Chronic Lymphocytic Leukemia: Case-Based Session Hematology, January 1, 2001; 2001(1): 140 - 156. [Abstract] [Full Text] [PDF]

	Blood Online is supported in part by Genentech BioOncology and Biogen Idec
	Copyright © 2001 by American Society of Hematology         Online ISSN: 1528-0020