LETTERS TO THE EDITOR Cytogenetics in Autologous Bone Marrow Transplantation

Autoh)gous hone marrow transplantation (ABMT) is used for marrow re(:onslitoli(m after intensive chemotherapy or irradiation or both in patients with w~rious real ignancies [1], but the so-calle, d m i n i m a l residual disease (MRD) remains a t)asic prohlem. hldeed, the marrow harw;sted for A B M T is often contaminated w i t h ne()plasti(: cells both in patients w i t h leukemia [2] or solid ttnnors [3[. As a (:onse(ttlence, the l)rincipal cause of death of patients who undergo A B M T for leukemia is recurrent (tisease, ew;n when attempts are made to purge the marrow with appropriate metho(ls I4]. We observed a case of T-cell a(:ute lymphohlasti(: leukemia (AI,I,) in whi(:h the cytogeneti(: study was instrumental in detecting MRI). C. F., a boy born in 1985, was diagnosed as having T-cell ALL of the L1 type (French-American-British (FAB) classification) in May 1987, when a chromosome analysis of bone marrow showed a translocation between the chromosomes 3 and 5 as the sole acquired anomaly. The karyotype was 46,XY,t(3;5)(q25:q22)/46,XY (Table 1). Chemotherapy consisted of vincristine, daunorubicin, L-asparaginase, prednisone, and then methotrexate. In January 1988, the morphological picture of a marrow biopsy indicated complete remission, and bone marrow cells were harvested for ABMT. A chromosomal analysis of this material showed one cell with the translocation (3;5) among the 36 cells examined. As a consequence ABMT was not performed and a severe relapse of the disease occurred in the following months, with evident proliferation of the clone with the t(3;5/ (Table 1). Several different assays have been developed to detect MRD in the various hematological diseases [5-7]. Some of them are very sensitive but useful only in selected cases (e.g., blast cells of c o m m o n or " n u l l " ALL phenotype, may barely be detected [7]). Our case indicates that chr(mlosome analysis may be very efficient in tracing MRI), and we suggest a systematic cytogeneti(: s(:re.ening of bone marrow (:ells harw~sh;d for ABMT.

Table 1 Date

Results of chromosome analyses No. of cells with t(3:51/ total no. of cells analyzed

11/2/1987 1/20/1988" 10/5/1988

17/22 1/36 19/31

Marrow harvested for autologous bone marr(~w transplantation.

137 © 1990 Elsevier Science Publishing Co., Inc. 655 A v e n u e of the Americas, New York, NY 10010

Cancer(;enet Cytogen(~t 45:137 138 (199(1) 0165-4608,'90,$03.50

138

E. Maserati et al.

Suilported by CNR, Progetlo Fim~lizzato Om:ol(/gia, (;rant No. 88.011669.44. E. C. is s u p p o r t e d /)v Ass()(:iazioile Studio Malformazioni. Milan, Italy. E M A N U E L A MASERATI ELENA C A M P A G N O L I F. TRUGLIO F. P O R T A L. NESPOLI G. R. BURGIO F. P A S Q U A L I

Biologia Generale e Genetica Medica Universita di Pavia C.P. 217, 1-27100, Pavia, Italy Clinica Pediatrica Universita di Pavia

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6. Philip l, Favrot M (1988): Cultures cellulaires dans le lymphome de Burkitt. Ddtection de la maladie rdsiduelle et application ~ la purge du greffon autologue. Pathol Biol 36:79-82. 7. Janossy G, CampaIla 1). Flt]rm,ql A, ( k m s l a n - S m i l h F, T i m m s A, Bekassy AN, t t a n n 1, Ak:orn MJ, T o t t e r m a n T, S i m o n s s o n B. l:](;nglsson M, I,aureni JC, P()n(:eh~,t P 11988): A u t o l o g o u s bone m a r r o w t r a n s p l a n t a t i o n in ~t(:Lltc lynq)hol)lasli(: h m k e m i a - - i ) r e c l i n i ( : a l i m m u n o l o g i c sludies. Leukcnfia 2:485 4!15.

Cytogenetics in autologous bone marrow transplantation.

LETTERS TO THE EDITOR Cytogenetics in Autologous Bone Marrow Transplantation Autoh)gous hone marrow transplantation (ABMT) is used for marrow re(:ons...
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