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Blood, 15 September 2001, Vol. 98, No. 6, pp. 1982-1985
BRIEF REPORT
The significance of graft-versus-host disease and
pretransplantation minimal residual disease status to outcome after
allogeneic stem cell transplantation in patients with acute
lymphoblastic leukemia
Mehmet Uzunel,
Jonas Mattsson,
Marie Jaksch,
Mats Remberger, and
Olle Ringdén
From the Department of Clinical Immunology and Center
for Allogeneic Stem Cell Transplantation, Karolinska Institute at
Huddinge University Hospital, Huddinge, Sweden.
Relapse is the major cause of treatment failure after
allogeneic stem cell transplantation (SCT) in patients with acute
lymphoblastic leukemia. Minimal residual disease (MRD) was
analyzed before SCT in 30 patients with acute lymphoblastic leukemia.
The aim was to determine whether the level of MRD before
transplantation was correlated with outcome. Fifteen patients were
found to have high-level MRD (10 2 to 103),
10 had low-level MRD (< 103), and 5 were
MRD. Among MRD patients the probability of
relapse was 0 in 5, which was less than in MRD+ patients
(13 of 25) (P = .05). No major difference was found between the high- and low-level MRD+ groups. Among the
MRD+ patients, only 2 of 11 with acute and chronic
graft-versus-host disease had a relapse, versus 11 of 14 without
(P = .005). In conclusion, for patients entering
transplantation while they have residual disease, a combination of
acute and chronic graft-versus-host disease may be needed to decrease
the risk of relapse after SCT.
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