Miyamoto T, Nagafuji K, Harada M, Niho Y
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Higashi-ku, Fukuoka, Japan.
Leuk Lymphoma. 1997 Mar;25(1-2):69-75. doi: 10.3109/10428199709042497.
Autologous peripheral blood stem cell transplantation (PBSCT) is replacing autologous bone marrow transplantation (BMT) in the treatment of leukemia. One of the potential advantages of autologous PBSCT is the possibility that peripheral blood stem cells (PBSC) are less likely to be contaminated by leukemic cells than bone marrow grafts. However, the major problem still remains the high incidence of leukemic relapse following autologous PBSCT, which may be caused by the reinfusion of PBSC contaminated by leukemic cells. Recently, we have developed a quantitative assay using competitive reverse transcriptase polymerase chain reaction that estimates the number of AML1/ETO transcripts in t(8;21) acute myelogenous leukemia (AML), in order to determine the degree of leukemic cell contamination in PBSC harvests, and to monitor minimal residual disease (MRD) quantitatively in patients with t(8;21) AML. Our data indicate that although PBSC harvests collected after consolidation chemotherapy are contaminated by leukemic cells, the degree of leukemic cell contamination decreases with repeated cycles of chemotherapy. Furthermore, the MRD in PBSC harvests is less than in the corresponding bone marrow obtained on the day of the PBSC collection. There appears to be no relationship between the number of AML1/ETO transcripts found in the infused PBSC harvests and the incidence of leukemic relapse following autologous PBSCT in our study. However, a substantial decrease of AML1/ETO transcripts was seen following autologous PBSCT. Thus, the quantitative analysis of AML1/ETO transcripts may be clinically useful in patients with t(8;21) AML.
在白血病治疗中，自体外周血干细胞移植（PBSCT）正在取代自体骨髓移植（BMT）。自体PBSCT的潜在优势之一是，外周血干细胞（PBSC）受白血病细胞污染的可能性可能低于骨髓移植物。然而，主要问题仍然是自体PBSCT后白血病复发的高发生率，这可能是由于输注了被白血病细胞污染的PBSC所致。最近，我们开发了一种使用竞争性逆转录聚合酶链反应的定量测定方法，用于估计t(8;21)急性髓性白血病（AML）中AML1/ETO转录本的数量，以确定PBSC采集中白血病细胞的污染程度，并对t(8;21) AML患者的微小残留病（MRD）进行定量监测。我们的数据表明，尽管巩固化疗后采集的PBSC被白血病细胞污染，但白血病细胞污染程度会随着化疗周期的重复而降低。此外，PBSC采集中的MRD低于PBSC采集当天获得的相应骨髓中的MRD。在我们的研究中，输注的PBSC采集中发现的AML1/ETO转录本数量与自体PBSCT后白血病复发的发生率之间似乎没有关系。然而，自体PBSCT后AML1/ETO转录本显著减少。因此，AML1/ETO转录本的定量分析可能对t(8;21) AML患者具有临床应用价值。
