Gaiger A, Lion T, Kalhs P, Mitterbauer G, Henn T, Haas O, Födinger M, Kier P, Forstinger C, Quehenberger P
First Department of Medicine, University of Vienna, Austria.
Leukemia. 1993 Nov;7(11):1766-72.
We performed a two-step polymerase chain reaction (PCR) to detect bcr-abl-specific mRNA in 440 peripheral blood and/or bone marrow samples of 30 chronic myeloid leukemia (CML) patients (mean 15, range 2-50 samples) following non T-cell-depleted allogeneic (n = 28) or syngeneic (n = 2) bone marrow transplantation (BMT). Median follow-up after BMT is 40 months (range 2-116 months), the median observation time 29 months (range 2-40 months). In 15 patients (50%), bcr-abl-specific mRNA could be detected following BMT. Bcr-abl positivity was rare in patients who were in hematological remission for at least 40 months (2/11). In five patients, PCR positivity was observed only once; all five patients are in complete hematological remission. Ten patients showed bcr-abl specific mRNA in two or more consecutive samples. Hematological relapse occurred in five of the latter patients. Bcr-abl positivity preceded hematological relapse in all cases. Bcr-abl positivity was detected more frequently in patients without graft-versus-host disease (GVHD) (11/15), than in patients with GVHD (4/15) (p < 0.02). Our data indicate that transient bcr-abl positivity is not usually followed by hematological relapse, while patients, who are positive in serial samples have a high risk of relapse.
我们进行了两步聚合酶链反应（PCR），以检测30例慢性髓性白血病（CML）患者（平均15例，范围2 - 50例样本）在非T细胞去除的异基因（n = 28）或同基因（n = 2）骨髓移植（BMT）后的440份外周血和/或骨髓样本中的bcr-abl特异性mRNA。BMT后的中位随访时间为40个月（范围2 - 116个月），中位观察时间为29个月（范围2 - 40个月）。15例患者（50%）在BMT后可检测到bcr-abl特异性mRNA。bcr-abl阳性在血液学缓解至少40个月的患者中很少见（2/11）。5例患者仅一次观察到PCR阳性；所有5例患者均处于完全血液学缓解状态。10例患者在两个或更多连续样本中显示bcr-abl特异性mRNA。后一组患者中有5例发生血液学复发。所有病例中bcr-abl阳性均先于血液学复发。无移植物抗宿主病（GVHD）的患者中bcr-abl阳性检出率（11/15）高于有GVHD的患者（4/15）（p < 0.02）。我们的数据表明，短暂的bcr-abl阳性通常不会继发血液学复发，而连续样本呈阳性的患者复发风险较高。
