BCR-ABL transcript level patterns after allograft is variable in chronic myeloid leukemia

08-02-2006

BCR-ABL transcript level patterns following stem cell transplantation is variable in patients with Philadelphia chromosome-positive chronic myeloid leukemia.

According to a recently published study from the United States, "We identified 243 patients with Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) who had BCR-ABL transcripts monitored by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) after allogeneic stem cell transplantation for a median of 84.3 months.

"Individual patients were regarded as having achieved molecular relapse (MR) if the BCR-ABL/ABL ratio exceeded 0.02% on 3 occasions or reached 0.05% on 2 occasions."

"Patients were allocated to 1 of 4 categories: (1) 36 patients were 'persistently negative' or had a single low-level positive result; (2) 51 patients, 'fluctuating positive, low level', had more than 1 positive result but never more than 2 consecutive positive results; (3) 27 patients, 'persistently positive, low level', had persisting low levels of BCR-ABL transcripts but never more than 3 consecutive positive results; and (4) 129 patients relapsed.

"In 107 of these, relapse was based initially only on molecular criteria; in 72 (67.3%) patients the leukemia progressed to cytogenetic or hematologic relapse either prior to or during treatment with donor lymphocyte infusions," reported J. Kaeda and colleagues at the U.S. National Institutes of Health.

The authors concluded that the "pattern of BCR-ABL transcript levels after allograft is variable; only a minority of patients with fluctuating or persistent low levels of BCR-ABL transcripts satisfied our definitions of MR, whereas the majority of patients who did so were likely to progress further."

Kaeda and colleagues published their study in Blood (Serial measurement of BCR-ABL transcripts in the peripheral blood after allogeneic stem cell transplantation for chronic myeloid leukemia: an attempt to define patients who may not require further therapy. Blood, 2006;107(10):4171-4176).

For more information, contact J.M. Goldman, NHLBI, Hematology Branch, Bldg 10, Room 3-5140, 10 Center Dr., Bethesda, MD 20892, USA.

Publisher contact information for the journal Blood is: American Society Hematology, 1900 M Street. NW Suite 200, Washington, DC 20036, USA.

Keywords: Bethesda, Maryland, United States, Chronic Myeloid Leukemia, BCR-ABL Transcripts, Stem Cell Transplantation, Prognostic Indicator.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2006, Clinical Oncology Week via NewsRx.com.