Early Relapse After High-Dose Chemotherapy Rescued by Tumor-Free Autologous Peripheral Blood Stem Cells in Acute Lymphoblastic Leukemia: Importance of Monitoring for WT1-mRNA Quantitatively

T. Sakatani Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

C. Shimazaki Second Department of Medicine, Kyoto Prefectural University of Medicine, KyotoCorrespondence[email protected]

H. Hirai Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

A. Okano Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

M. Hatsuse Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

A. Okamoto Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

R. Takahashi Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

E. Ashihara Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

T. Inaba Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

H. Yokota Department of Clinical Laboratory Medicine, Tokyo University, Tokyo, Japan

K. Nakahara Department of Clinical Laboratory Medicine, Tokyo University, Tokyo, Japan

H. Hirai Department of Cell Therapy and Transplantation Medicine, Tokyo University, Tokyo, Japan

M. Nakagawa Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto

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Abstract

A 24-year-old woman who suffered from ALL with MLL gene rearrangement received high-dose chemotherapy followed by autologous PBSC transplantation during complete remission (CR). Reverse transcriptase-polymerase chain reaction (RT-PCR) used to detect MLL/LTG4 chimeric mRNA showed no minimal residual disease (MRD) in the graft or bone marrow at the transplantation. However, the leukemia relapsed four months after transplantation. Retrospective analysis of quantitative measurement of Wilms tumor gene (WT-1) mRNA showed an increased level in the bone marrow although it was within the normal range. These observations suggest that careful monitoring of MRD by quantitative measurement of WT-1 mRNA in addition to disease-specific chimeric mRNA is required to predict relapse.

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Early Relapse After High-Dose Chemotherapy Rescued by Tumor-Free Autologous Peripheral Blood Stem Cells in Acute Lymphoblastic Leukemia: Importance of Monitoring for WT1-mRNA Quantitatively

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Early Relapse After High-Dose Chemotherapy Rescued by Tumor-Free Autologous Peripheral Blood Stem Cells in Acute Lymphoblastic Leukemia: Importance of Monitoring for WT1-mRNA Quantitatively

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