Complete disease responses after HCT.
(A) Example of molecular remission of CML (patient FH14726) induced by HCT without DLI, as documented by failure of reverse transcription–PCR to detect bcr-abl transcripts. The lane described “−ve” is a negative control of normal bone marrow (BM). K562 is a positive control for bcr-abl. (B) Example of molecular remission of CLL induced by HCT (patient FH12914) without DLI, as documented by PCR to detect a tumor-specific immunoglobulin heavy-chain gene rearrangement (arrow). Each posttransplantation sample was amplified in duplicate. The lanes designated 10−1 to 10−5 show a dilution series of the patient's pretransplantation sample (more than 90% tumor cells) into normal bone marrow. (C) Example of complete remission of MM (patient FH13922) after allogeneic HCT. The patient was initially treated with 4 cycles of vincristine, adriamycin, and dexamethasone (VAD). High-dose cytoreduction with melphalan 200 mg/m2 and autologous transplantation were performed 3 months before allogeneic HCT. DLI was given 4 months after HCT because of persistent tumor. After CR was achieved, trace levels of serum monoclonal paraprotein detected by immunofixation were present intermittently in follow-up testing.
