Autologous Bone Marrow Transplantation - Blog Science Connections

172 Detecting Residual Disease in Bone Marrow
tumor cell. Qualitative and quantitative assessment of residual disease involves
several fields such as cytogenetics, molecular biology, cell culture, and
immunology combined with standard optical microscopy or flow cytometry
and cytomorphometric analysis in automated systems.
The aims of recent local and national French meetings have been to
analyze previously described techniques in order to define their methodological
constraints, to compare the reproducibility and reliability of their results, and to
search for a process to increase their sensitivity through possibly combining
several methods to detect residual disease. Further, all techniques are not equal
in detecting residual disease. They differ in complexity, reliability, sensitivity,
and type of results (Table 1). Appraising these methods requires a multiparametric
analysis including cost and daily clinical application (1).
Table 1. Panel of Bone Marrow Residual Disease Detection Methods
Before Bone
Bone Marrow At Marrow Clonal
Detection Markers Leukemia Diagnosis Harvesting Marker
Immunology
CD2-CD8 T-ALL ++
CD11-CD15 ANLL +
CD9, CD10,
CD19, CD20,
CD24 Non-T-ALL ++
Antigen density (CALLA) C-ALL (+) (+)
Chromosome analysis 8
t(4;11) ALL (5%)
t(9;22) ALL (6-19%)
t(1;19)
pre-B-ALL(30%)
t(15;17) AML (M 3 )
Aneuploidy
(flow cytometry)
Mutation at the
DNA level
Clonal DNA
rearrangement
T B genes
Heavy chain Ig gene
Light chain Ig gene
ALL/ANLL
ANLL
T-ALL
Non-T-ALL
Non-T-ALL
Note: ++, high value; +, intermediate value; (+), low value; -, no information.
"These are
examples.
Abbreviations: CD, cluster of differentiation; T-ALL, T-cell acute lymphoblastic
leukemia; ANLL, acute nonlymphocytic leukemia; CALLA, common acute
lymphoblastic leukemic antigen; C-ALL, common acute lymphoblastic leukemia; ALL,
acute lymphoblastic leukemia; B-ALL, B-cell acute lymphoblastic leukemia; Ig,
immunoglobulin.