Elmaagacli A H, Beelen D W, Kroll M, Trzensky S, Stein C, Schaefer U W
Department of Bone Marrow Transplantation, University Hospital of Essen, Germany.
Bone Marrow Transplant. 1998 Jan;21(2):159-66. doi: 10.1038/sj.bmt.1701056.
We evaluated the occurrence of the CBFbeta/MYH11 fusion transcripts by PCR analysis in 10 patients with inv(16)(p13;q22) acute myeloid leukemia (AML) who underwent allogeneic bone marrow transplantation (BMT) (n = 5), peripheral blood progenitor cell transplantation (PBPCT) (n = 3), or autologous transplantation (n = 2). In addition to the analysis of minimal residual disease (MRD), the chimerism status of patients after allogeneic transplant was studied by PCR. The CBFbeta/MYH11 fusion transcript was not detectable in six of seven patients who remained in remission after allogeneic BMT or PBPCT. Two of these patients in remission were monitored for 50 months and 64 months post-BMT. One patient in remission was PCR-positive for CBFbeta 3 months post-BMT in a single BM sample, but not in a simultaneously examined blood sample, suggesting that analyses from BM samples are more sensitive than those from blood samples. Sequential PCR assays performed 6 and 12 months post-BMT obtained from the same patient were negative. Another patient with a positive PCR assay 3 months post-allogeneic PBPCT, remained PCR positive for the CBFbeta/MYH11 fusion transcript when tested 6 months post-PBPCT. A chimerism analysis by PCR revealed a mixed chimerism status in this patient. He relapsed 7 months post-transplant. Before transplant, in all nine patients who were in complete remission of AML (eight patients in 1CR, one patient in 2CR), the CBFbeta/MYH11 transcript was detectable. In one patient in relapse, the fusion transcript was not only detectable in blood and bone marrow, but also in a cerebrospinal fluid sample prior to transplant. Two patients who received autologous BMT were monitored for CBFbeta/MYH11 transcripts 3 months after BMT. The CBFbeta/MYH11 was detected in these patients. Both patients subsequently relapsed 3 months and 23 months post-autologous BMT. The results study show that analysis of the CBFbeta/MYH11 fusion transcript by PCR seems to be a suitable method for monitoring minimal residual disease in AML patients with inv (16).
我们通过聚合酶链反应（PCR）分析评估了10例inv(16)(p13;q22)急性髓系白血病（AML）患者中CBFβ/MYH11融合转录本的出现情况，这些患者接受了异基因骨髓移植（BMT）（n = 5）、外周血祖细胞移植（PBPCT）（n = 3）或自体移植（n = 2）。除了分析微小残留病（MRD）外，还通过PCR研究了异基因移植后患者的嵌合状态。在7例异基因BMT或PBPCT后仍处于缓解期的患者中，有6例未检测到CBFβ/MYH11融合转录本。其中2例缓解期患者在BMT后分别接受了50个月和64个月的监测。1例缓解期患者在BMT后3个月的单个骨髓样本中CBFβ PCR检测呈阳性，但同时检测的血液样本中未检测到，这表明骨髓样本分析比血液样本分析更敏感。对同一患者在BMT后6个月和12个月进行的连续PCR检测均为阴性。另1例异基因PBPCT后3个月PCR检测呈阳性的患者，在PBPCT后6个月检测时，CBFβ/MYH11融合转录本PCR检测仍为阳性。PCR嵌合分析显示该患者为混合嵌合状态。他在移植后7个月复发。移植前，在所有9例AML完全缓解的患者中（8例处于第1次完全缓解，1例处于第2次完全缓解），均可检测到CBFβ/MYH11转录本。1例复发患者在移植前，不仅在血液和骨髓中可检测到融合转录本，在脑脊液样本中也可检测到。2例接受自体BMT的患者在BMT后3个月监测CBFβ/MYH11转录本。在这些患者中检测到了CBFβ/MYH11。这2例患者随后分别在自体BMT后3个月和23个月复发。研究结果表明，通过PCR分析CBFβ/MYH11融合转录本似乎是监测inv(16) AML患者微小残留病的一种合适方法。
