M. Eder et al., Monitoring of BCR-ABL expression using real-time RT-PCR in CML after bone marrow or peripheral blood stem cell transplantation, LEUKEMIA, 13(9), 1999, pp. 1383-1389
To analyze the value of real time RT-PCR for monitoring of bcr-abl expressi
on in CML patients after allogeneic or autologous stem cell transplantation
(SCT), we generated pairs of PCR-primers and TaqMan probes specific for ei
ther the b2a2- or the b3a2-variant of bcr-abl. Either variant could be dete
cted specifically from cDNA from a single K562 (b3a2) and BV173 (b2a2) cell
with the respective TaqMan probe. Bcr-abl expression was normalized by com
parison with GAPDH expression, and samples were quantitated using standard
cDNA dilutions from K562 or BV173 cells. In a retrospective analysis 13 pat
ients with CML after allogeneic (n = 10) or autologous (n = 3) SCT includin
g patients with relapsed or persistent CML were analyzed by both real-time
and conventional nested RT-PCR. In addition chimerism was monitored by FISH
analysis of sex chromosomes in three patients with relapsed disease. The b
cr-abl/GAPDH ratio dropped at least 1000-fold in all seven patients evaluab
le prior to and after allogeneic SCT as estimated by real-time RT-PCR, and
conventional RT-PCR became negative in 6/7 patients. In five patients with
relapsed or persistent disease after allogeneic SCT the bcr-abl/GAPDH ratio
eventually increased again, and real-time RT-PCR was as sensitive as conve
ntional RT-PCR for detection of bcr-abl. Donor lymphocyte infusions (DLI) w
ere given to all five patients, and the bcr-abl/GAPDH ratio dropped to unde
tectable levels in two patients both remaining in continuing molecular remi
ssion. In contrast, in three other patients the bcr-abl/GAPDH ratio decreas
ed only or did not change significantly after DLI. In three patients underg
oing autologous SCT the bcr-abl/GAPDH ratio dropped only 1.1 to 30-fold, an
d the patients were tested positive with real-time RT-PCR at all time point
s. These data demonstrate that real-time RT-PCR is valuable to quantitate b
cr-abl expression in CML patients after transplantation.