chapter  16
16 Pages

Detection and Significance of Minimal Residual Disease from Solid Tumor Malignancies in Stem Cell Autografts

ByAmy A. Ross

I. INTRODUCTION The increasing use of autologous stem cell transplantation (ASCT) as a means of hematopoietic reconstitution following high-dose chemotherapy (HDC) has heightened the concern about tumor contamination of autologous grafts. Post-ASCT relapse may be due to persistence of disease, the infusion of clonogenic tumor cells, or a combination of the two. Although no study to date has demonstrated that infused tumor cells in contaminated ASCT grafts are solely responsible for posttransplant relapse, the presence of gene-marked, infused tumor cells at sites of disease relapse has been documented in three malignancies (1-3). The presence of tumor cells in autologous grafts is also correlated with poor post-ASCT clinical outcome in a variety of solid-tumor malignancies (4-8). Thus, the sensitive and specific identification of minimal residual disease (MRD) in ASCT grafts is of great concern.