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Prepublished online as a Blood First Edition Paper on August 29, 2002; DOI 10.1182/blood-2002-02-0571.
Submitted February 21, 2002
Accepted August 19, 2002
Kinetics of minimal residual disease and chimerism in patients with chronic myeloid leukemia after non-myeloablative conditioning and allogeneic stem cell transplantation
Mehmet Uzunel*, Jonas Mattsson, Mats Brune, Jan-Erik Johansson, Johan Aschan, and Olle Ringden
Department of Clinical Immunology, Huddinge University Hospital, Stockholm, Sweden; Center for Allogeneic Stem Cell Transplantation (CAST), Huddinge University Hospital, Stockholm, Sweden
Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
Center for Allogeneic Stem Cell Transplantation (CAST), Huddinge University Hospital, Stockholm, Sweden; Department of Hematology, Huddinge University Hospital, Stockholm, Sweden
* Corresponding author; email: Mehmet.Uzunel{at}impi.ki.se.
The kinetics of minimal residual disease (MRD) and chimerism were studied in 15 patients with chronic myeloid leukemia (CML) receiving non-myeloablative stem cell transplants (NST) and in 10 patients receiving conventional stem cell transplants (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 only mixed 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 to 0.01% in CST patients (p<0.01). However, 12 months posttransplant, the percentage of 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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