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Long persistent bcr-abl positive transcript detected by polymerase chain
reaction after marrow transplant for chronic myelogenous leukemia without
clinical relapse: a study of 64 patients
K Miyamura, T Tahara, M Tanimoto, Y Morishita, K Kawashima, Y Morishima, H Saito, S Tsuzuki, K Takeyama and Y Kodera
First Department of Internal Medicine, Nagoya University School of
Medicine, Japan.
We report here the results of polymerase chain reaction (PCR) for bcr- abl
transcript and clinical details derived from 64 chronic myelogenous
leukemia (CML) patients after allogeneic bone marrow transplantation (BMT).
A total of 139 samples (2 to 220 weeks after BMT) were analyzed and bcr-abl
transcript was detected in 99 samples from 52 patients. Patients were
defined as bcr-abl early negative (EN) if they had > or = 1 negative PCR
result < or = 1 year post-BMT (n = 13), and bcr-abl late positive (LP)
if they had > or = 1 positive PCR result > or = 1 year post-BMT (n =
21). Among LP patients, only two patients had hematologic/cytogenetic
(clinical) relapse. Another 19 LP patients remained in clinical remission 7
to 130 weeks after positive analysis for bcr-abl transcript, including 5
patients who had persistent bcr-abl transcript detectable even 2 years
after BMT. To estimate the relationship between clinical data and residual
bcr-abl transcript, EN patients are compared with LP patients. However, no
clinical data studied were significantly associated with the persistent PCR
positivity. If only patients in chronic phase are compared, the t-test
showed significant correlation between leukocyte count just before BMT and
sustained bcr-abl transcript (P < .05). These results suggest that PCR
positivity is frequently observed in CML patients who sustain clinical
remission after BMT, without being predictive of imminent clinical relapse.
Tumor burden at the time of BMT may play an important role in the latency
of bcr-abl positivity after BMT.
Volume 81,
Issue 4,
pp. 1089-1093,
02/15/1993
Copyright © 1993 by The American Society of Hematology
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