RESUMEN
A real-time quantitative-polymerase chain reaction (RQ-PCR) targeting the immunoglobulin heavy chain (IgH) gene has been used for the quantification of minimal residual disease (MRD) in B-cell hematological malignancies. In non-Hodgkin lymphoma (NHL), experimental costs are increased, as a large number of primer-probe sets are required because of diversity, due to somatic and ongoing mutations of the IgH gene. We developed an allele-specific oligonucleotide (ASO) combined with a germline consensus probe-based RQ-PCR assay and examined MRD in peripheral blood stem cells (PBSC). The IgH consensus probes were adapted in seven (50%) of 14 amplifiable cases. Patients with heavily contaminating tumor cells in PBSC relapsed after PBSC transplantation. Our strategy will contribute to the development of a cost-efficient, precisely quantitative and systemic detection assay for MRD in NHL.
Asunto(s)
Genes de Inmunoglobulinas/genética , Linfoma de Células B/terapia , Neoplasia Residual/diagnóstico , Células Neoplásicas Circulantes/patología , Trasplante de Células Madre de Sangre Periférica/métodos , Reacción en Cadena de la Polimerasa/métodos , Adolescente , Adulto , Anciano , Alelos , Secuencia de Bases , Secuencia de Consenso , Cartilla de ADN/economía , Cartilla de ADN/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Oligonucleótidos , Trasplante de Células Madre de Sangre Periférica/normas , Reacción en Cadena de la Polimerasa/economía , Reacción en Cadena de la Polimerasa/normas , Sensibilidad y Especificidad , Trasplante AutólogoRESUMEN
The biological significance of CD56 antigen expression in patients with acute promyelocytic leukemia (APL) has been under investigation. We investigated the clinical and biologic features of CD56+APL. In our series, CD56 antigen was positive in 4 of 28 (14%) APL patients. No differences were found regarding age, gender, performance status (PS), initial leukocyte and platelet counts, lactate dehydrogenase (LDH) and fibrinogen (Fbg) levels according to CD56 expression. CD34 antigen was co-expressed in 3 of the 4 patients with CD56+ APL, in contrast to 2 of the 24 patients with CD56- APL (P = .01). Extramedullary relapse occurred in 3 of the 4 patients with CD56+ APL, in contrast to none of the 24 patients with CD56- APL (P = .001). Median remission duration was 4 months in CD56+ APL and was not reached in CD56- APL. The CD56+ population had a shorter remission duration (P < .0001) and disease-free survival (P < .0001). In contrast, no difference was found in overall survival. These results suggested that CD56 expression was associated with the leukemogenetic mutation at the primitive hematopoietic progenitor cell level and extramedullary relapse in APL patients treated with ATRA and chemotherapy.