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Molecular studies in patients with chronic myeloid leukaemia in remission 5 years after allogeneic stem cell transplant define the risk of subsequent relapse
Author(s) -
Mughal Tariq I.,
Yong Agnes,
Szydlo Richard M.,
Dazzi Francesco,
Olavarria Eduardo,
Van Rhee Frits,
Kaeda Jaspal,
Cross Nick C. P.,
Craddock Charles,
Kanfer Ed,
Apperley Jane,
Goldman John M.
Publication year - 2001
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2001.03155.x
Subject(s) - medicine , transplantation , gastroenterology , chronic myeloid leukaemia , hematology , oncology , immunology
We identified 103 consecutive patients who, 5 years after allogeneic transplantation for chronic myeloid leukaemia (CML), were in molecular remission (MR). The 103 patients were divided into three groups on the basis of reverse transcription–polymerase chain reaction (RT–PCR) studies for BCR‐ABL transcripts in the first 5 years post transplant: Group A comprised 63 patients who had been continuously PCR negative; Group B comprised 20 patients with one or more positive PCR result but only at a low level; and Group C comprised 20 patients who had fulfilled the criteria for molecular relapse, been treated with donor lymphocyte infusions (DLI) and had thereafter regained complete MR within the 5‐year post‐transplant period. The median follow‐up for all 103 patients was 8·4 years from transplant (range 5–17·6 years). In group A only one patient relapsed at 9·2 years. In group B eight patients (40%) relapsed: six at molecular, one at cytogenetic and one haematological levels. The actuarial probabilities of survival at 10 years for patients in Groups A, B and C were 97·4%, 92·9% and 100% respectively; the probabilities of relapse were 3%, 54% and 0% respectively. We conclude that molecular studies during the first 5 years post transplant can help to predict long‐term leukaemia‐free survival and, possibly, cure of CML.