Myeloid mixed chimerism is associated with relapse in bcr-abl positive patients after unmanipulated allogeneic bone marrow transplantation for chronic myelogenous leukemia

• Published in: Haematologica (Roma) Vol. 85; no. 2; pp. 173 - 180
• Main Authors: Roman, J, Serrano, J, Jimenez, A, Castillejo, JA, Reina, ML, Gonzalez, MG, Rodriguez, MC, Garcia, I, Sanchez, J, Maldonado, J, Torres, A
• Format: Journal Article
• Language: English
• Published: Pavia Haematologica 01-02-2000
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone Marrow Transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Child; Female; Follow-Up Studies; Fusion Proteins, bcr-abl - genetics; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - genetics; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - immunology; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - pathology; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Male; Medical sciences; Middle Aged; Recurrence; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation Chimera - genetics; Transplantation Chimera - immunology; Transplantation Immunology; Transplantation, Homologous; Chromosomal aberration; Human; Relapse; Homograft; Malignant hemopathy; Philadelphia chromosome; Myeloproliferative syndrome; Chronic; Treatment; Mixed; C-Onc gene; Chronic myelocytic leukemia; Cytogenetics; Bone marrow; Abnormal chromosome; Genetics; Graft; Chimerism; Hybrid gene; Protooncogene; Chromosome translocation
• ISSN: 0390-6078; 1592-8721

Servicio de Hematologia, Hospital Reina Sofia, 14004 Cordoba, Spain. [e-mail].
BACKGROUND AND OBJECTIVE: Although bcr-abl polymerase chain reaction (PCR) positivity after bone marrow transplantation (BMT) for chronic myelogenous leukemia (CML) is significantly related to relapse, the predictive value of the assay is not very high and therefore most investigators consider that qualitative RT-PCR data alone are too imprecise to enable clinical decisions to be taken in individual cases. To define the clinical outcome of bcr-abl positive patients after unmanipulated BMT better, we sought the origin of hematopoiesis and traced its evolution over time. DESIGN AND METHODS: Forty-nine patients received allogeneic BMT for CML (39 in chronic phase and 10 in accelerated phase/blast crisis). Median follow-up was 61 months (range 4-92). mRNA and DNA were used to assess bcr-abl and chimerism status respectively. Quantitative VNTR-PCR on total cells and lymphoid or myeloid population allowed us to assign and measure the origin of hematopoiesis. RESULTS: Both bcr-abl positivity and the presence of mixed chimerism (MC) were significantly associated with relapse (p = 0.0009 and p