In search of the original leukemic clone in chronic myeloid leukemia patients in complete molecular remission after stem cell transplantation or imatinib

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Sobrinho Simoes, M (Author) FMUP; Wilczek, V (Author) Other; Score, J (Author) Other; Cross, NCP (Author) Other; Apperley, JF (Author) Other; Melo, JV (Author) Other

Journal

Title: Blood

Vol. 116

Pages: 1329-1335

ISSN: 0006-4971

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 59 Citations

Scopus - 68 Citations

Other information

Authenticus ID: P-003-3X0

DOI: 10.1182/blood-2009-11-255109

Abstract (EN): It is not clear if absence of BCR-ABL transcripts-complete molecular response (CMR)-is synonymous with, or required for, cure of chronic myeloid leukemia (CML). Some patients achieve CMR with imatinib (IM), but most relapse shortly after treatment discontinuation. Furthermore, most patients in long-term remission (LTR) post-stem cell transplantation (SCT) are considered functionally cured, although some remain occasionally positive for low-level BCR-ABL mRNA. Interpretation of the latter is complicated be-cause it has been observed in healthy subjects. We designed a patient-specific, highly sensitive, DNA quantitative polymerase chain reaction to test follow-up samples for the original leukemic clone, identified by its unique genomic BCR-ABL fusion (gBCR-ABL). In 5 IM-treated patients in CMR, gBCR-ABL was detected in transcript-negative samples; 4 patients became gBCR-ABL-negative with continuing IM therapy. In contrast, of 9 patients in LTR (13-27 years) post-SCT, gBCR-ABL was detected in only 1, despite occasional transcript-positive samples in 8 of them. In conclusion, in IM-treated patients, absence of transcripts should not be interpreted as absence of the leukemic clone, although continuing IM after achievement of CMR may lead to further reduction of residual disease. Post-SCT, we found little evidence that the transcripts occasionally detected originate from the leukemic clone. (Blood. 2010; 116(8): 1329-1335)

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7