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Type: Journal article
Title: Significance of molecular marker-positive cells after autologous peripheral-blood stem-cell transplantation for non-Hodgkin's lymphoma
Author: Hardingham, J.
Kotasek, D.
Sage, R.
Gooley, L.
Mi, J.X.
Dobrovic, A.
Norman, J.
Bolton, A.
Dale, B.
Citation: Journal of Clinical Oncology, 1995; 13(5):1073-1079
Publisher: Lancaster Press
Issue Date: 1995
ISSN: 0732-183X
Abstract: <h4>Purpose</h4>To evaluate the significance of molecular marker-positive cells in a cohort of non-Hodgkin's lymphoma (NHL) patients undergoing high-dose chemotherapy and autologous peripheral-blood stem-cell transplantation (PBSCT).<h4>Patients and methods</h4>Twenty-eight PBSC transplants have been performed in 24 patients with poor-prognosis NHL. Molecular analysis of the t(14;18) (q32;q21) translocation (bcl-2/immunoglobulin [Ig] heavy-chain joining locus [JH] fusion) or antigen receptor gene rearrangements was performed to determine the presence of lymphoma cells at presentation, in PBSC harvests, and before and after autologous PBSCT. Kaplan-Meier estimates of survival and Cox regression analyses were used to test the effect of bone marrow involvement, tumor-cell contamination of PBSCs, disease stage, and chemotherapy sensitivity at transplantation, and presence of marker-positive cells post-PBSCT on disease-free and overall survival.<h4>Results</h4>Thirteen of 24 patients (54%) are alive following PBSCT at a median follow-up time of 654 days (range, 193 to 1,908). Nine patients are in complete remission (CR) at day 216 to 1,799 (median, 805) and four are alive following relapse (day 440, 573, 1,188, and 1,908). Eleven patients (46%) have died: three of transplant-related complications at day 0, 1, and 13, and eight of recurrent disease (day 132 to 1,330; median, 451). Longitudinal marker studies post-PBSCT showed that of 16 relapse events, 13 (81%) were positive for the lymphoma marker at or before clinically documented relapse. Marker studies became negative post-PBSCT in nine of nine patients who entered and remained in CR. Disease-free survival (DFS) was significantly shortened in patients in whom marker-positive cells were detected in serial samples posttransplantation (P = .006). Cox regression analysis showed that patients in this group had a 24 times higher risk of relapse (P = .03).<h4>Conclusion</h4>The results show that the reappearance or persistence of marker-positive cells after autologous PBSCT is strongly associated with relapse.
Keywords: Humans
Lymphoma, Non-Hodgkin
Translocation, Genetic
Genetic Markers
Neoplasm Staging
Disease-Free Survival
Treatment Outcome
Combined Modality Therapy
Hematopoietic Stem Cell Transplantation
Blotting, Southern
Regression Analysis
Survival Analysis
Cohort Studies
Polymerase Chain Reaction
Middle Aged
Rights: © 1995 by American Society of Clinical Oncology
DOI: 10.1200/JCO.1995.13.5.1073
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Appears in Collections:Aurora harvest 7
Physiology publications

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