@article{Orietta Spinelli_Barbara Peruta_Manuela Tosi_Vittoria Guerini_Anna Salvi_Maria Cristina Zanotti_Elena Oldani_Anna Grassi_Tamara Intermesoli_Caterina Micò_Giuseppe Rossi_Pietro Fabris_Giorgio Lambertenghi-Deliliers_Emanuele Angelucci_Tiziano Barbui_Renato Bassan_Alessandro Rambaldi_2007, place={Pavia, Italy}, title={Clearance of minimal residual disease after allogeneic stem cell transplantation and the prediction of the clinical outcome of adult patients with high-risk acute lymphoblastic leukemia}, volume={92}, url={https://haematologica.org/article/view/4432}, DOI={10.3324/haematol.10965}, abstractNote={<strong>Background and Objectives</strong> The molecular analysis of minimal residual disease (MRD) may provide informaton on the risk of recurrence in patients with acute lymphoblastic leukemia (ALL). The aim of this study was to correlate the kinetics of MRD clearance after allogeneic transplantation with the clinical outcome of adults with ALL.<strong>Design and Methods</strong> MRD was evaluated by real-time quantitative polymerase chain reaction (RQ-PCR) using probes derived from fusion chimeric genes (<em>BCR/ABL</em> and <em>MLL/AF4</em>) (n=22) or rearrangements of the T-cell receptor or immunoglobulin genes (n =21). Forty-three adult patients with ALL were studied to correlate the kinetics of MRD clearance before and after allogeneic hematopoietic stem cell transplantation.<strong>Results</strong> At 36 months, the overall survival of patients who underwent transplantation in hematologic remission (n = 37) was 80% for those who were PCR-negative before transplantation (n = 12) compared to 49% for PCR-positive patients (n = 25)(<em>p</em>=0.17). For the same patients the cumulative incidence of relapse was 0% and 46%, respectively (<em>p</em>=0.027). Moreover, the relapse rate of patients who were PCR-negative at day +100 after transplantation was remarkably low (7%) compared to that among patients who were PCR-positive (80%, <em>p</em>=0.0006).<strong>Interpretation and Conclusions</strong&gt; The kinetics of MRD clearance may help to identify patients at high risk of leukemia relapse after allogeneic stem cell transplantation. Patients not achieving an early molecular remission after transplantation require prompt and appropriate pre-emptive treatments such as infusions of donor lymphocytes or new experimental drugs.}, number={5}, journal={Haematologica}, author={Orietta Spinelli and Barbara Peruta and Manuela Tosi and Vittoria Guerini and Anna Salvi and Maria Cristina Zanotti and Elena Oldani and Anna Grassi and Tamara Intermesoli and Caterina Micò and Giuseppe Rossi and Pietro Fabris and Giorgio Lambertenghi-Deliliers and Emanuele Angelucci and Tiziano Barbui and Renato Bassan and Alessandro Rambaldi}, year={2007}, month={May}, pages={612-618} }