Detection of Minimal Residual Disease by bcl-2 PCR in Early Stage Follicular Lymphomas

OncologyONCOLOGY Vol 13 No 3
Volume 13
Issue 3

The polymerase chain reaction (PCR) assay provides a powerful means of detecting minimal residual disease in follicular


The polymerase chain reaction (PCR) assay provides a powerful means of detecting minimal residual disease in follicular lymphoma. Most available data, however, are on stage IV cases.

We tested the blood of 86 patients with stage I-III previously untreated follicular lymphoma before and after therapy with three objectives: (1) to determine the frequency of positive PCR at diagnosis; (2) to examine the correlation of molecular response (conversion to negative PCR in blood) with clinical outcome; and (3) to evaluate the molecular response rate of three different treatment approaches. These consisted of: (1) central lymphatic radiation (mantle plus whole-abdominopelvic radiation) in 23 patients; (2) COP (cyclophosphamide, Oncovin, and prednisone)/CHOP (cyclophosphamide, doxorubicin HCl, Oncovin, and prednisone) with or without involved-field radiation in 43 patients; and (3) chemotherapy alone with an intensive regimen (three alternating combinations [“ATT”]) in 20 patients.

Of 86 patients tested at baseline for both mbr and mcr breakpoints, 74 (86%) were positive in blood. The table below shows the projected failure-free survival (FFS) at 7 years according to the molecular response at 3, 6, and 12 months during therapy:

CONCLUSION: (1) In spite of localized stage, most cases had circulating bcl-2 rearranged cells. (2) Radiation, although a local treatment, resulted in a relatively high systemic molecular response rate. (3) Achievement of early molecular response (3 months) correlated best with clinical outcome. (4) ATT induced a significantly higher molecular response at 3 months, as compared with COP/CHOP with or without radiation.

Click here for Dr. Bruce Cheson’s commentary on this abstract.

Articles in this issue

WHO Declares Lymphatic Mapping to Be the Standard of Care for Melanoma
Rituximab: Phase II Retreatment Study in Patients With Low-Grade or Follicular Non-Hodgkin’s Lymphoma
Response Criteria for NHL: Importance of “Normal” Lymph Node Size and Correlations With Response
Chemotherapy Plus Radiation Improves Survival in Patients With Cervical Cancer
A Randomized Trial of Fludarabine, Mitoxantrone (FM) Versus Doxorubicin, Cyclophosphamide, Vindesine, Prednisone (CHEP) as First Line Treatment in Patients With Advanced Low-Grade Non-Hodgkin's Lymphoma: A Multicenter Study by GOELAMS Group
Navelbine Increased Elderly Lung Cancer Patients’ Survival
Fludarabine Versus Conventional CVP Chemotherapy in Newly C Diagnosed Patients With Stages III and IV Low-Grade Malignant Non-Hodgkin’s Lymphoma: Preliminary Results From a Prospective, Randomized Phase III Clinical Trial in 381 Patients
Multicenter, Phase III Study of Iodine-131 Tositumomab (Anti-B1 Antibody) for Chemotherapy-Refractory Low-Grade or Transformed Low-Grade Non-Hodgkin’s Lymphoma
T-Cell–Depleted Allogeneic Bone Marrow Transplant From HLA-Matched Sibling Donors for Non-Hodgkin’s Lymphoma
Consensus Statement on Prevention and Early Diagnosis of Lung Cancer
In Vivo Purging and Adjuvant Immunotherapy With Rituximab During PBSC Transplant For NHL
Fludarabine and Cyclophosphamide: A Highly Active and Well-Tolerated Regimen for Patients With Previously Untreated Indolent Lymphomas
Campath-1H Monoclonal Antibody in Therapy for Advanced Low-Grade Non-Hodgkin’s Lymphomas: A Phase II Study
AIDS Drugs Effective Against Most Common HIV Strain
Rituximab Therapy in Previously Treated Waldenström’s Macroglobulinemia: Preliminary Evidence of Activity
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