Survey of early disapearance of BCR/ABL fusion transcript after allogeneicor autologous stem cell transplantation for chronic myelogenous leukemia

The detection of BCR-ABL specific RNA by RT-PCR has been shown to predict r elapse when positive 6 months after allogeneic stem cell transplantation (S CT) for chronic myelogenous leukemia (CML). In the present study, the focus was on evaluation of residual disease during the first weeks following SCT . In this study, 177 blood or marrow samples were obtained from 33 patients who received allogeneic (20 patients) or autologous (13 patients) SCT on d ay 0, day 30 and every 3 months for 1 year. T-cell depletion (TCD) was perf ormed in 4 cases. On day 0 (day of graft infusion), 10/30 evaluable patient s had negative RT-PCR (33%) regardless of pretransplant characteristics. On day 30, 14/18 patients (77%) from the allogeneic group had negative RT-PCR versus 0% in the autologous group. 2/4 patients who received TCD allogenei c grafts had day 30-positive PCR. Five patients in the allogeneic group had at least one positive RT-PCR sample between day 30 and day 90: 3 of them s ubsequently relapsed suggesting possible correlation between early positivi ty and relapse. Our results show that disappearance of MRD, can be achieved within 3 months after transplantation in the majority of patients treated with allogeneic but not after autologous SCT. This suggests that the GVL effect might be op erational early during the first weeks following transplantation.