Summary
EWS/ets-oncogene fusions that result from the rearrangement of chromosome 22 observed in Ewing’s tumors (ET) provide tumor-specific markers that can be used to detect contaminating tumor cells in bone marrow (BM) and peripheral blood (PB) samples by means of a highly sensitive reverse-transcriptase-polymerase chain reaction technique (RT-PCR). We analyzed BM samples obtained from 59 ET patients at diagnosis. Additional PB samples from 15 patients were available for RT-PCR. Median observation time of 42 ET patients was long enough to calculate overall and event-free survival curves according to the presence or absence of tumor cells in BM as detected by RT-PCR.
At diagnosis, 49% of ET patients had BM positivity detected by RT-PCR (32% in clinically localized and 72% in metastatic ET patients, respecively). No correlation with clinical parameters such as size, localization, histology, or type of fusion transcript of the tumor was found. BM positivity was associated with the presence of clinically metastatic disease and a statistically significant unfavorable outcome in univariate analysis. In contrast, the overall and eventfree survival of 24 ET patients with localized disease did not reveal statistically significant differences between the presence or absence of RT-PCR detected tumor cells in BM. PB samples from non-metastatic ET patients were negative and circulating tumor. cells were detected in only 50% of clinically metastatic patients.
These results suggest that BM is a more appropriate target for the detection of occult tumor cells than PB. However, to date RT-PCR detected BM contamination cannot be considered to be an established risk factor in staging procedures. Further studies are needed to appreciate the relationship and independence of BM positivity in ET patients.
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Dockhorn-Dworniczak, B. et al. (2000). Molecular Genetic Detection of Minimal Metastatic and Residual Disease in Ewing’s Tumors. In: Berdel, W.E., et al. Transplantation in Hematology and Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59592-9_21
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DOI: https://doi.org/10.1007/978-3-642-59592-9_21
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