Seventy-two patients with non-Hodgkin's lymphoma were evaluated for the presence of molecular markers (IgH, bcl-1, bcl-2 rearrangement) on bone marrow, at diagnosis and after PBSCT, and on harvests in order to find a possible predictive role of minimal residual disease on treatment outcome. At diagnosis, 41 (59%) out of 69 available bone marrows showed molecular involvement. Fifty-six percent of leukaphereses were involved, mainly indolent lymphoma (P = 0.001) or advanced disease (P = 0.01). Ex vivo purging cleared only one stem collection out of 31 PCR-positive leukaphereses. Aggressive lymphomas showed both a longer overall survival (OS) (P = 0.03) and relapse-free survival RFS (P = 0.02) when transplanted with unpurged stem cells, whereas indolent NHL survival was not influenced by ex vivo purging. Twenty out of 26 samples taken during follow-up had bone marrow involvement at diagnosis. Of these, 15 cleared their bone marrow; both OS and RFS were significantly longer in the PCR-negative cases (P = 0.05 and P = 0.005). At 1 year after PBSCT, 75% of patients were PCR negative, with 50% molecular remissions; the relapse rate was 55% for patients still PCR positive vs 29% for those who were PCR negative. Thus, after high-dose chemotherapy, close molecular monitoring of MRD using qualitative PCR techniques seems to represent a reliable prognostic indicator.
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|Data di pubblicazione:||2002|
|Titolo:||Minimal residual disease - The role of molecular monitoring in autotransplantation for non-Hodgkin's lymphoma|
|Autori:||S. Galimberti; R. Marasca; F. Caracciolo; R. Fazzi; F. Papineschi; E. Benedetti; F. Guerrini; F. Morabito; E. Oliva; N. Di Renzo; M. Federico; M. Petrini; G. Torelli|
|Autori interni:||MARASCA, Roberto |
|Digital Object Identifier (DOI):||0.1038/sj/bmt/1703422|
|Rivista:||BONE MARROW TRANSPLANTATION|
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