Detection of bcl-2/IgH rearrangements by quantitative-competitive PCR and capillary electrophoresis

Background: PCR is the primary method for detecting minimal residual diseas e in hematologic cancers. One such gene target is the bcl-2/immunoglobulin heavy chain (IgH) translocation found in a majority of cases of follicular lymphoma. Methods and Results: We report an accurate method for quantitative detectio n of the bcl-2/IgH translocation marker of follicular lymphoma in a series of patients in various stages of remission and relapse who had been treated with a combination of ifosfamide, mitoxantrone, and etoposide (MIN-E) chem otherapy and monoclonal anti-CD20 antibody (Rituximab). The approach uses s eminested PCR followed by analysis of the products on a fluorescent capilla ry electrophoresis system. The quantitation of bcl-2/IgH translocation-posi tive cells was sensitive and reproducible, capable of detecting as few as f ive malignant cells out of 300,000 normal cells. Conclusion: Quantitative PCR enables one to monitor the kinetics of tumor r eduction in patients treated with MINE chemotherapy in combination with Rit uximab.