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Peripheral blood vs. bone marrow for molecular monitoring of BCR‐ABL1 levels in chronic myelogenous leukemia, a retrospective analysis in allogeneic bone marrow recipients
Author(s) -
BALLESTRERO A.,
CIRMENA G.,
DOMINIETTO A.,
GARUTI A.,
ROCCO I.,
CEA M.,
MORAN E.,
NENCIONI A.,
MIGLINO M.,
RAIOLA A. M.,
BACIGALUPO A.,
PATRONE F.
Publication year - 2010
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/j.1751-553x.2009.01198.x
Subject(s) - chronic myelogenous leukemia , medicine , bone marrow , minimal residual disease , leukemia , peripheral blood , breakpoint cluster region , kappa , gastroenterology , oncology , immunology , receptor , linguistics , philosophy
Summary Molecular monitoring of the BCR‐ABL1 transcript in chronic myelogenous leukemia (CML) using quantitative real‐time PCR (RQ‐PCR) can be performed using either bone marrow (BM) or peripheral blood (PB). However, a recent report by Stock et al. [ International Journal of Oncology 28 (2006) 1099] questioned the reliability of PB samples for BCR‐ABL1 detection as performed by RQ‐PCR. We report a study on 114 CML patients who received allogeneic stem cell transplantation (ASCT), and who were monitored by RQ‐PCR using paired samples of BM and PB: the total number of determinations was 428, with a median follow‐up after transplant of 8 years. BCR‐ABL1 transcript was undetectable or <0.1%, in 106 (49.57%) and 62 (29%) paired determinations, respectively. BCR‐ABL1 was >0.1% in 36 (16.8%) paired determinations and was discordant in 10 (4.7%). Agreement between PB and BM results was quantified by the kappa test ( k = 0.85; 95% CI 0.76–0.94). This study shows that BCR‐ABL1 RQ‐PCR monitoring of CML patients after ASCT with PB is concordant with BM in 95.3% of cases, and thus may be used to monitor the disease. This may be relevant when discussing both quality of life issues and the need for post‐transplant monitoring with the patient.