2007 Fiscal Year Final Research Report Summary
A New Strategy of Leukemia Therapy based on Minimal Residual Disease
| Project/Area Number |
17590497
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Laboratory medicine
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| Research Institution | Kyoto Prefectural University of Medicine |
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Principal Investigator |
YOKOTA Shohei Kyoto Prefectural University of Medicine, Dept. Medicine, Associate Professor (80231687)
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| Project Period (FY) |
2005 – 2007
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| Keywords | leukemia / minimal residual disease / multi-center study |
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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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