| Budget Amount *help |
¥3,560,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2007: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2006: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 2005: ¥1,000,000 (Direct Cost: ¥1,000,000)
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| Research Abstract |
This research project is designed to establish a new strategy of therapy for adult ALL. Patients enrolled in this study are classified by the amount of minimal residual disease (MRD). The markers of MRD are the clonally rearranged genes of T-cell receptor delta or gamma chain and immunoglobulin heavy or kappa chain. They are detected by the amplification using patient-specific oligo-primers.
We take the bone marrow samples four times in early stage after every unit of chemotherapy (A1/C1/A2/C2) to evaluate the reduction of leukemic cells. According to the residual amount, the patients are classified into two groups. In cases with quick and sustained reduction, the patients are treated with a conventional chemotherapy. Those with residual leukemic cells are advised to have bone marrow transplantation.
100 cases have been enrolled in the study in the past 4 years. Median age was 45.75.8% of the patients had at least one clonal rearrangement. This number is nearly the same as childhood ALL. The percentage of MRD-positive patients are as follows, 57%, 83%, 87%, and 88%, at Al, Cl, A2, and C2, respectively. 17 patients who had a single positive result at C1, A2 or C2 are classified as candidates for allogeneic transplantation.
Although farther observation is required to draw any conclusion for clinical benefits from this protocol, we could carry out the MRD-based therapy safely in multi-center trial.
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