Molecular monitoring of the tumor load predicts progressive disease in patients with multiple myeloma after high-dose therapy with autologous peripheral blood stem cell transplantation

Citation
E. Lipinski et al., Molecular monitoring of the tumor load predicts progressive disease in patients with multiple myeloma after high-dose therapy with autologous peripheral blood stem cell transplantation, BONE MAR TR, 28(10), 2001, pp. 957-962
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Medical Research Diagnosis & Treatment
Journal title
BONE MARROW TRANSPLANTATION
ISSN journal
0268-3369 → ACNP
Volume
28
Issue
10
Year of publication
2001
Pages
957 - 962
Database
ISI
SICI code
0268-3369(200111)28:10<957:MMOTTL>2.0.ZU;2-0
Abstract
The clinical relevance of the assessment of minimal residual disease (MRD) in patients with multiple myeloma (MM) to predict disease recurrence has no t been proven. In the present study, we retrospectively analyzed the tumor load in peripheral blood (PB) and bone marrow (BM) samples of 13 patients w ith MM both in remission after high-dose therapy (RDT) with autologous PBSC transplantation (PBSCT) and at the time of progressive disease (PD). For s ix patients, subsequent samples obtained in remission could be included in the study. Tumor cells were assessed by means of quantitative PCR with alle le-specific oligonucleotides (ASO-qPCR) based on the method of limiting dil utions. PD was documented with ASO-qPCR in BM samples (median concentration of tumor cells in remission vs at PD: 0.18% vs 4.6%) representing a signif icant increase by a median factor of 8.7. In PB, the median tumor load was 799 cells/ml in remission and 23 400 cells/ml at PD. With a median factor o f 45, the increase was much more pronounced. Comparing the results of the m olecular monitoring in PB with those of the determination of the monoclonal protein, routinely applied as parameter for the course of the disease, rev ealed a superiority of the molecular monitoring because of the significantl y higher increase in the tumor load. Analyzing the subsequent remission sam ples showed an increase of the malignant cells in four out of six PB sample s and in all four BM samples available, indicating the potential of ASO-qPC R for an early PD recognition.