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Prepublished online as a Blood First Edition Paper on August 29, 2002; DOI 10.1182/blood-2002-02-0571.
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Blood, 15 January 2003, Vol. 101, No. 2, pp. 469-472
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Brief report
Kinetics of minimal residual disease and chimerism in patients
with chronic myeloid leukemia after nonmyeloablative conditioning and
allogeneic stem cell transplantation
Mehmet Uzunel,
Jonas Mattsson,
Mats Brune,
Jan-Erik Johansson,
Johan Aschan, and
Olle Ringdén
From the Department of Clinical Immunology, Center for
Allogeneic Stem Cell Transplantation (CAST), and Department of
Hematology, Karolinska Institute at Huddinge University Hospital,
Stockholm, Sweden; and Department of Medicine, Sahlgrenska
University Hospital, Gothenburg, Sweden.
The kinetics of minimal residual disease (MRD) and chimerism
were studied in 15 patients with chronic myeloid leukemia (CML) receiving nonmyeloablative stem cell transplantation (NST) and in 10 patients receiving conventional stem cell transplantation (CST). All
NST patients showed T-cell mixed chimerism (MC) while granulocyte and
B-cell MC occurred in 80% and 60% of the NST patients, respectively.
In CST patients, T-cell MC was detected in 5 patients, of whom 3 were
mixed only during the first month. MRD was detected in all NST
patients. During the first 3 months the median BCR-ABL/ABL ratio was
0.2% in NST patients compared with 0.01% in CST patients (P < .01). However, 12 months after transplantation, the
percentage of reverse transcriptase-polymerase chain reaction
(RT-PCR)-positive patients was 20% in NST patients and 50% in CST
patients. In conclusion, molecular remission can be induced in most
patients after NST, albeit with different kinetics from CST.
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