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Eradication of residual bcr-abl-positive clones by inducing graft-versus-host disease after allogeneic stem cell transplantation in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia

Bone Marrow Transplantation volume 29, pages 63–66 (2002)Cite this article

Abstract

Persistence of bcr-abl transcripts after marrow grafting is thought to convey a high risk for relapse in patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL). Donor leukocyte infusion (DLI) is closely associated with development of graft-versus-host disease (GVHD) and has well-defined activity against relapsed chronic myelogenous leukemia (CML) but not ALL. We report two patients with Ph-positive ALL who remained bcr-abl positive by reverse transcriptase polymerase chain reaction (RT-PCR) after marrow grafting. Residual bcr-abl transcripts in both patients were eliminated following acute GVHD, which was induced by either DLI or rapid reduction of immunosuppression. Both patients have continued in complete molecular remission for 18 months and 8 months following transplantation, respectively. Our observation suggests that induction of GVHD may eliminate minimal residual disease, thereby preventing leukemia relapse in patients transplanted for Ph-positive ALL.

Bone Marrow Transplantation (2002) 29, 63–66. doi:10.1038/sj.bmt.1703318

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Acknowledgements

We thank the staff of the Hematology/Oncology ward at the Kameda General Hospital for providing excellent care of our patients. We are indebted to Prof Kazuo Oshimi (Juntendo University Medical School) for his critical reading of the manuscript.

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  1. Division of Hematology/Oncology, Department of Medicine, Kameda General Hospital, Kamogawa, Chiba, Japan

    K Matsue, T Tabayashi, K Yamada & M Takeuchi

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  1. K Matsue
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  2. T Tabayashi
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  3. K Yamada
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  4. M Takeuchi
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Matsue, K., Tabayashi, T., Yamada, K. et al. Eradication of residual bcr-abl-positive clones by inducing graft-versus-host disease after allogeneic stem cell transplantation in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Bone Marrow Transplant 29, 63–66 (2002). https://doi.org/10.1038/sj.bmt.1703318

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