Detection of tumor load in chronic myeloid leukemia during treatment with transplantation by conventional cytogenetics, nested-RT-PCR and FISH / 中国实验血液学杂志

ABSTRACT

This study was purposed to investigate the sensitivity and specificity of conventional cytogenetics (CC), nested-reverse transcriptase polymerase chain reaction (nested-RT-PCR) and dual-color/dual-fusion fluorescence in situ hybridization (D-FISH) technique in monitoring the tumor load of chronic myeloid leukemia (CML) during treatment with transplantation. CC, nested-RT-PCR and interphase D-FISH were simultaneously carried out to detect the tumor load of 7 CML patients during treatment with non-myeloablative allogeneic stem cell transplantation (allo-NSCT). 40 specimens from 7 CML patients before and after allo-NSCT were analyzed. The results showed that 29 specimens were Ph (+) with different positive ratio and 3 specimens with lower cells were not analyzed by CC. 36 specimens were bcr/abl mRNA (+) by RT-PCR. 4 specimens from case 1 at 12, 18, 26 and 38 months after allo-NSCT were Ph (-) and bcr/abl mRNA (-), 4 Ph (-) bcr/abl (+) specimens containing 2 from case 1 at 9 and 10 months after allo-NSCT, 1 from case 2 at 15 months after allo-NSCT, 1 from case 3 at 12 months after allo-NSCT showed 5.4%, 0%, 16.5% and 1.5% bcr/abl (+) cells by FISH. 3 specimens with lower cells containing 2 from case 5 at 20 and 60 days after allo-NSCT and 1 from case 7 at 40 days after allo-NSCT were analyzed by FISH and showed 55.0%, 27.5% and 73.5% bcr/abl (+) cells. The Ph (-) bcr/abl (-) specimen from case 1 at 12 months post-allo-NSCT showed 0% bcr/abl (+) cells by FISH. It is concluded that CC can be used as a basic tool to monitor the change of tumor load in CML during treatment. When specimen with lower cells can not be analyzed by CC in early period after allo-NSCT, or result of CC can not evaluate precisely dynamic change of tumor load and when tumor load in treated patient are lower to Ph (-) by CC while bcr/abl mRNA (+) by RT-PCR, FISH must be used to detect precisely tumor load and monitor dynamic change of it. More sensitive RT-PCR is used to monitor tumor load when it is lower to bcr/abl (-) by FISH during treatment.