Περίληψη:
In chronic myeloid leukemia, accurate determination of Ph- Hemopoietic
stem cells (HSC) in peripheral blood (PB), bone marrow (BM) and
leukapheresis products is important for the selection of patients for
whom mobilization, collection, and autografting of Ph- HSC are
envisaged. To this effect, the BCR/ABL fusion was assessed at the single
cell level in 25 sets of PB and BM samples using dual-color I-FISH in
immunophenotyped CD34(+) cells and RT-PCR of individual CFU-GM colonies.
In 15 cases found to be 100% Ph+, the respective BCR/ABL gene was
absent in 30% of CD34(+) cells, while the respective transcripts could
not be identified in 17% of CFU-GM. The mean percentage of BCR/ABL(-)
CD34(+) cells and CFU-GM cells was higher (38% and 29%, respectively)
in untreated patients than in treated patients (24% and 7%,
respectively). In eight cases with cytogenetic response (CgR), the
percentage of Ph- metaphases correlated with the level of BCR/ABL(-)
colonies in BM and PB and with the proportion of BCR/ABL(-) CD34(+)
cells in the BM. Immunophenotyping and FISH was fast, easy, always
informative, and quantitative for the BCR/ABL- CD34(+) cells. Our
results show that (a) at early diagnosis a high frequency of BCR/ABL(-)
HSC circulate in the PB and that Ph- hematopoiesis is not completely
suppressed: (b) although normal clonogenic cells decline rapidly within
a few months after diagnosis, appreciable numbers of normal CD34(+)
cells survive in chronic phase, especially in patients with CgR. (C)
2000 Elsevier Science Inc. All rights reserved.
Συγγραφείς:
Akel, S
Kolialexi, A
Mavrou, A
Metaxotou, C
Loukopoulos,
D
Yataganas, X
