Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI
Aim: To demonstrate quantitative assessment of tumor response to treatment in patients with follicular lymphoma using parallel monitoring of minimal residual disease (MRD) and diffusion-weighted MRI (MRI-DWI) derived apparent diffusion coefficient (ADC). Materials and Methods: Two patients with foll...
Gespeichert in:
| Datum: | 2015 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | English |
| Veröffentlicht: |
Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України
2015
|
| Schriftenreihe: | Experimental Oncology |
| Schlagworte: | |
| Online Zugang: | http://dspace.nbuv.gov.ua/handle/123456789/145560 |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Назва журналу: | Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| Zitieren: | Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI / A.N. Meleshko, S.A. Kharuzhyk, N.A. Piatrouskaya // Experimental Oncology. — 2015. — Т. 37, № 4. — С. 295-297. — Бібліогр.: 17 назв. — англ. |
Institution
Digital Library of Periodicals of National Academy of Sciences of Ukraine| id |
irk-123456789-145560 |
|---|---|
| record_format |
dspace |
| spelling |
irk-123456789-1455602019-01-24T01:23:20Z Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI Meleshko, A.N. Kharuzhyk, S.A. Piatrouskaya, N.A. Case report Aim: To demonstrate quantitative assessment of tumor response to treatment in patients with follicular lymphoma using parallel monitoring of minimal residual disease (MRD) and diffusion-weighted MRI (MRI-DWI) derived apparent diffusion coefficient (ADC). Materials and Methods: Two patients with follicular lymphoma were undergone synchronous evaluation of MRD and MRI-DWI at definite time points before, during and after chemotherapy. MRD level was calculated in diagnostic and follow up samples relative to the highest level of amplification of the target. Allele-specific primer for clonal IgH gene rearrangement was used as a target for real-time quantitative polymerase chain reaction (PCR). 1.5 Tesla scanner was used for MRI-DWI. The largest non necrotic lymph node was chosen for serial ADC measurement. Results: In first patient MRD reduced drastically in blood after chemotherapy but persisted at low level in bone marrow. Whole body MRI-DWI demonstrated regression of most of tumor lesions except one marginally enlarged iliac lymph node and allowed to predict tumor progression in this particular anatomical site based on low ADC value after treatment. In the second patient all three methods (MRD, ADC and radiologic evaluation) gave concordant result of complete tumor response and patient remained in a clinical remission during follow-up time. Conclusion: Quantitative PCR measurement may detect very low level of MRD in patients with follicular lymphoma which may have prognostic value. Combination of both PCR-based MRD and quantitative evaluation of MRI-DWI derived ADC provides safe added-value disease monitoring in lymphoma. Key Words: follicular lymphoma, minimal residual disease, diffusion-weighed MRI, apparent diffusion coefficient, response monitoring. 2015 Article Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI / A.N. Meleshko, S.A. Kharuzhyk, N.A. Piatrouskaya // Experimental Oncology. — 2015. — Т. 37, № 4. — С. 295-297. — Бібліогр.: 17 назв. — англ. 1812-9269 http://dspace.nbuv.gov.ua/handle/123456789/145560 en Experimental Oncology Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
| institution |
Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| collection |
DSpace DC |
| language |
English |
| topic |
Case report Case report |
| spellingShingle |
Case report Case report Meleshko, A.N. Kharuzhyk, S.A. Piatrouskaya, N.A. Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI Experimental Oncology |
| description |
Aim: To demonstrate quantitative assessment of tumor response to treatment in patients with follicular lymphoma using parallel monitoring of minimal residual disease (MRD) and diffusion-weighted MRI (MRI-DWI) derived apparent diffusion coefficient (ADC). Materials and Methods: Two patients with follicular lymphoma were undergone synchronous evaluation of MRD and MRI-DWI at definite time points before, during and after chemotherapy. MRD level was calculated in diagnostic and follow up samples relative to the highest level of amplification of the target. Allele-specific primer for clonal IgH gene rearrangement was used as a target for real-time quantitative polymerase chain reaction (PCR). 1.5 Tesla scanner was used for MRI-DWI. The largest non necrotic lymph node was chosen for serial ADC measurement. Results: In first patient MRD reduced drastically in blood after chemotherapy but persisted at low level in bone marrow. Whole body MRI-DWI demonstrated regression of most of tumor lesions except one marginally enlarged iliac lymph node and allowed to predict tumor progression in this particular anatomical site based on low ADC value after treatment. In the second patient all three methods (MRD, ADC and radiologic evaluation) gave concordant result of complete tumor response and patient remained in a clinical remission during follow-up time. Conclusion: Quantitative PCR measurement may detect very low level of MRD in patients with follicular lymphoma which may have prognostic value. Combination of both PCR-based MRD and quantitative evaluation of MRI-DWI derived ADC provides safe added-value disease monitoring in lymphoma. Key Words: follicular lymphoma, minimal residual disease, diffusion-weighed MRI, apparent diffusion coefficient, response monitoring. |
| format |
Article |
| author |
Meleshko, A.N. Kharuzhyk, S.A. Piatrouskaya, N.A. |
| author_facet |
Meleshko, A.N. Kharuzhyk, S.A. Piatrouskaya, N.A. |
| author_sort |
Meleshko, A.N. |
| title |
Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI |
| title_short |
Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI |
| title_full |
Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI |
| title_fullStr |
Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI |
| title_full_unstemmed |
Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI |
| title_sort |
response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted mri |
| publisher |
Інститут експериментальної патології, онкології і радіобіології ім. Р.Є. Кавецького НАН України |
| publishDate |
2015 |
| topic_facet |
Case report |
| url |
http://dspace.nbuv.gov.ua/handle/123456789/145560 |
| citation_txt |
Response monitoring in follicular lymphoma by synchronous evaluation of minimal residual disease and diffusion-weighted MRI / A.N. Meleshko, S.A. Kharuzhyk, N.A. Piatrouskaya // Experimental Oncology. — 2015. — Т. 37, № 4. — С. 295-297. — Бібліогр.: 17 назв. — англ. |
| series |
Experimental Oncology |
| work_keys_str_mv |
AT meleshkoan responsemonitoringinfollicularlymphomabysynchronousevaluationofminimalresidualdiseaseanddiffusionweightedmri AT kharuzhyksa responsemonitoringinfollicularlymphomabysynchronousevaluationofminimalresidualdiseaseanddiffusionweightedmri AT piatrouskayana responsemonitoringinfollicularlymphomabysynchronousevaluationofminimalresidualdiseaseanddiffusionweightedmri |
| first_indexed |
2025-07-10T21:57:33Z |
| last_indexed |
2025-07-10T21:57:33Z |
| _version_ |
1837298789458640896 |
| fulltext |
Experimental Oncology 37, 295–297, 2015 (December) 295
RESPONSE MONITORING IN FOLLICULAR LYMPHOMA
BY SYNCHRONOUS EVALUATION OF MINIMAL RESIDUAL DISEASE
AND DIFFUSION-WEIGHTED MRI
A.N. Meleshko1, S.A. Kharuzhyk2, N.A. Piatrouskaya2,*
1Center for Pediatric Oncology, Hematology and Immunology, Minsk 223053, Belarus
2N.N. Alexandrov National Cancer Center of Belarus, Minsk 223040, Belarus
Aim: To demonstrate quantitative assessment of tumor response to treatment in patients with follicular lymphoma using parallel
monitoring of minimal residual disease (MRD) and diffusion-weighted MRI (MRI-DWI) derived apparent diffusion coefficient (ADC).
Materials and Methods: Two patients with follicular lymphoma were undergone synchronous evaluation of MRD and MRI-DWI
at definite time points before, during and after chemotherapy. MRD level was calculated in diagnostic and follow up samples relative
to the highest level of amplification of the target. Allele-specific primer for clonal IgH gene rearrangement was used as a target for
real-time quantitative polymerase chain reaction (PCR). 1.5 Tesla scanner was used for MRI-DWI. The largest non necrotic lymph
node was chosen for serial ADC measurement. Results: In first patient MRD reduced drastically in blood after chemotherapy but
persisted at low level in bone marrow. Whole body MRI-DWI demonstrated regression of most of tumor lesions except one marginally
enlarged iliac lymph node and allowed to predict tumor progression in this particular anatomical site based on low ADC value after
treatment. In the second patient all three methods (MRD, ADC and radiologic evaluation) gave concordant result of complete tumor
response and patient remained in a clinical remission during follow-up time. Conclusion: Quantitative PCR measurement may detect
very low level of MRD in patients with follicular lymphoma which may have prognostic value. Combination of both PCR-based MRD
and quantitative evaluation of MRI-DWI derived ADC provides safe added-value disease monitoring in lymphoma.
Key Words: follicular lymphoma, minimal residual disease, diffusion-weighed MRI, apparent diffusion coefficient, response
monitoring.
Achievements in the field of non-Hodgkin lym-
phomas (NHL) molecular biology lead to progressive
development of treatment personalization. At the same
time they provide an option for accurate response
monitoring and prognostication. A range of laboratory
molecular techniques are available in lymphoma [1].
Evaluation of minimal residual disease (MRD) is used
as supporting and additional data which help in re-
sponse assessment fulfilled by conventional clinical
and diagnostic imaging methods [2]. MRD is defined
as any approach aimed at detecting and possibly quan-
tifying residual tumor cells beyond the sensiti vity level
of routine imaging and laboratory techniques [3]. MRD
has established role in leukaemias where it is used
to detect persistent leukaemic cells in bone marrow
or blood. High sensitivity of the test allows detecting
leukaemic cells at level down to one cell per million.
It was shown that MRD level after chemotherapy for
acute lymphoblastic leukaemia is closely related to the
probability of relapse [4]. To lesser extent MRD was
studded in patients with indolent NHL, primarily fol-
licular and mantle cell lymphomas [5–7].
Computed tomography (CT) or 18F-fluorodeoxy-
glucose-PET are standard methods for diagnostics,
response evaluation and follow-up of patients with
NHL. Before, during and after treatment numerous
CT and FDG-PET exams are performed that leads
to accumulation of ionizing radiation dose and increasing
risk of secondary malignancy development, especially
in children and young patients [8, 9]. MRI with diffu-
sion-weighed imaging (MRI-DWI) is a radiation-free
and highly sensitive method for detection of nodal
and extranodal lesions in lymphoma [10, 11]. DWI
is a MRI pulse sequence specially designed to detect
microscopic water molecules movement in tissues
and fluids in vivo. In solid tumors water diffusion takes
place mainly in the intercellular spaces. In lymphomas
diffusion in restricted because of increased cellular
density and high nuclear to cytoplasm ratio allowing
to characterize tumor at the cellular level. Because
of high safety profile MRI-DWI may be repeated during
and after treatment as many times as needed for treat-
ment monitoring and follow-up. Another advantage
of DWI compared to other MRI pulse sequences
is a quantitative evaluation using apparent diffusion
coefficient (ADC). Solid malignant tumors including
lymphomas are characterized by low ADC, generally
below 1–1.2•10–3 mm2/s [12, 13]. During effective cy-
totoxic treatment ADC increases because of cell death
mechanisms such as apoptosis and necrosis [14].
Due to quantitative nature MRD and MRI-DWI might
be used in parallel to monitor tumor response in NHL.
MATERIALS AND METHODS
In frame of clinical projects “Idiotype DNA vaccines
for B-cell NHL” and “MRI-DWI diagnostics in patients
with lymphomas” synchronous evaluation of MRD and
MRI-DWI derived ADC was performed in 2 patients with
Submitted: December 01, 2015.
*Correspondence: E-mail: savitri@tut.by
Abbreviations used: ADC — apparent diffusion coefficient;
CT — computed tomography; DWI — diffusion-weighted imaging;
FDG — fluorodeoxyglucose; MRI — magnetic resonance imaging;
MRD — minimal residual disease; NHL — non-Hodgkin lymphoma;
PET — positron emission tomography; RQ-PCR — real-time quanti-
tative polymerase chain reaction.
Exp Oncol 2015
37, 4, 295–297
CASE REPORTS
296 Experimental Oncology 37, 295–297, 2015 (December)
follicular lymphoma at the definite time points before,
during and after treatment. Patients got standard
diagnostic imaging tests for tumor staging, response
evaluation and follow-up according to current practice
in our institution.
MRD detection was performed as previously de-
scribed [15]. DNA from primary removed neck lymph
node was used for target identification and standard
curve construction. Allele-specific primer for clonal
IgH gene rearrangement was used as a target for real-
time quantitative polymerase chain reaction (RQ-PCR)
measurement [16]. MRD level was calculated in diag-
nostic and follow up samples relative to the highest
level of amplification of the target.
1.5 Tesla scanner was used for MRI-DWI. Scanning
technique was previously described [11]. Staging and
treatment response assessment was based on whole
body MRI-DWI. For serial ADC measurement the
largest non necrotic lymph node (target lesion) was
chosen on staging MRI-DWI. Lymph node was con-
toured on three diffusion-weighted images with largest
tumor dimensions using scanner software. Contours
were automatically transferred to corresponding ADC
maps. Mean signal intensity on ADC map corresponds
to tumor ADC value. ADC values on three slices were
averaged in order to get a lesion ADC.
RESULTS AND DISCUSSION
A 28-year-old woman (patient 1) was diagnosed
with follicular B-cell NHL involving axillary, me-
diastinal, mesenteric, paraaortic, iliac lymph nodes
and bone marrow, Ann Arbor stage IV (Figure). Im-
munohistochemistry: CD20+++, CD5−, CD3−, cyclin
D1−, CD21−, CD23−, Ki-67 up to 20%. A patient was
undergone to eight courses of chemotherapy FC
(fludarabine, cyclophosphamide). Before and after
first, before and after second, before third course and
after chemotherapy (8 courses) synchronous quan-
titative evaluation of MRD and ADC was performed
(Table 1). During chemotherapy PCR-based MRD
reduced drastically in blood but persisted at low level
in bone marrow. Paraaortic lymph node measuring
6.2×4.2 cm was chosen for serial ADC evaluation.
ADC value of target lesion increased gradually from
0.51 to 1.59•10–3 mm2/s corresponding to size nor-
malization of most lymph nodes at restaging except
right iliac one. ADC value of this lymph node was still
low at the end of treatment (0.95•10–3 mm2/s) showing
chemotherapy resistance. Tumor progression deve-
loped in this region one month later.
a b
Figure. Whole body DWI of patient 1 with follicular lymphoma
before treatment (a) and after 8 courses of chemotherapy (b).
Inverted gray scale maximum intensity projection images are
presented. Axillary, mediastinal, mesenteric, paraaortic and iliac
lymph nodes were initially involved (a). After chemotherapy all
lesions regressed except right iliac lymph node (arrow on b).
Physiologic diffusion restriction in the brain, spinal cord, spleen,
ovaries and endometrium is noted
Table 1. Serial MRD, ADC and radiological evaluation in patient 1 with follicular NHL
Time point MRD ADC, ×10–3 mm2/s Radiologic evaluation
1 month before treatment Tissue of lymph node 85.85%
Peripheral blood 2.52% − −
Staging immediately before treatment Peripheral blood 15%
Bone marrow 100%
Paraaortic lymph node 0.51
Right iliac lymph node 0.59
Whole body MRI-DWI: lesions of left axillary, mediastinal,
mesenteric, paraaortic, iliac lymph nodes and bone marrow
Immediately after FC 1 − Paraaortic lymph node 0.75 −
Immediately before FC 2 Peripheral blood 0.002% Paraaortic lymph node 0.96 −
Immediately after FC 2 Peripheral blood 0.008% Paraaortic lymph node 1.15 −
Immediately before FC 3 Peripheral blood 0% Paraaortic lymph node 1.19 −
Restaging after 8 courses of che-
motherapy (partial response)
Peripheral blood 0%
Bone marrow 0.002%
Paraaortic lymph node 1.59
Right iliac lymph node 0.95
Whole body MRI-DWI: upper diaphragm all lesions
regressed, lower diaphragm — right iliac lymph
nodes up to 1.3 cm
Follow-up 2 months after treatment
(progression) Peripheral blood 0.002% − Ultrasound: right iliac lymph node enlarged to 2.5×1.6 cm
4 months follow-up (further pro-
gression) Peripheral blood 0.009% − CT scan: right iliac lymph node enlarged to 4.9×4.5 cm,
all other lymph nodes are normal in size
Table 2. Serial MRD, ADC and radiological evaluation in patient 2 with follicular NHL
Time point MRD ADC, ×10–3 mm2/s Radiologic evaluation
Staging before treatment Tissue of lymph node 100%
Peripheral blood 75,67%
Left iliac lymph node 0.54 Whole body MRI-DWI: lesions of cervical, supracla-
vicular, infraclavicular, axillary, mediastinal, mesen-
teric, paraaortic, iliac, inguinal lymph nodes, spleen
and bone marrow
Restaging after 8 courses of chemotherapy
(complete response)
Peripheral blood 0% Left iliac lymph node 1.53 Whole body MRI-DWI: all lesions regressed
Follow-up 5 months after treatment (remission) Peripheral blood 0% − Abdominal and pelvic MRI-DWI: no lesions detected
Experimental Oncology 37, 295–297, 2015 (December) 297
A patient 2 is a 43-year-old woman diagnosed with
follicular B-cell NHL involving cervical, supraclavicular,
infraclavicular, axillary, mediastinal, mesenteric, para-
aortic, iliac, inguinal lymph nodes, spleen and bone
marrow, Ann Arbor stage IV. Immunohistochemistry:
CD20+++, bcl6+++, CD10+++, bcl2++, CD21−/+, cyclin D1−,
CD5−, CD3−, Ki-67 more than 40%. A patient was un-
dergone to eight courses of chemotherapy R-CHOP
(rituximab, cyclophosphamide, doxorubicin, vincris-
tine, prednisolon). Before and after chemotherapy
(8 courses) synchronous quantitative evaluation of MRD
and ADC was performed (Table 2). Left iliac lymph node
was chosen as a target for ADC measurement. After end
of chemotherapy MRD was not detectable in the blood
any more, target lesion ADC increased to the level above
1.5•10–3 mm2/s and radiological evaluation showed
complete response of all tumors. Patient remains in re-
mission during 6 months of follow-up.
In this report we present clinical cases of two pa-
tients with follicular NHL treated with chemotherapy
with serial MRD and MRI-DWI examination. Results
of MRD, ADC and radiological evaluation at different
time points before, during and after treatment are
presented. In patient 1 whole body MRI-DWI after
eight courses of chemotherapy demonstrated regres-
sion of most of tumor lesions. Only iliac lymph node
remained marginally enlarged measuring 1.3 cm. Such
small lymph nodes might be difficult to detect and even
more difficult to characterize by conventional imaging
techniques such as CT, ultrasonography or MRI. DWI
with ADC calculation is a functional imaging technique
which allowed to predict tumor progression in this par-
ticular anatomical site based on low ADC value after
treatment. In the patient 2 all three methods (MRD,
ADC and radiologic evaluation) gave concordant result
of complete tumor response and patient remained
in a clinical remission during follow-up time.
In the published literature MRD was used in patients
with indolent lymphomas for molecular monitoring
of treatment response and as a surrogate marker for
prognosis. In follicular lymphoma negative PCR-based
MRD status after rituximab treatment predicted higher
freedom from recurrence rate — 57% compared with
20% in patients with molecular positivity [6]. In ad-
vance stage follicular lymphoma patients achieved
an adequate remission with induction therapy PCR
detectable disease in the bone marrow before au-
tologous stem cell transplantation was the strongest
predictor of decreased progression-free survival [17].
To best of our knowledge our report is the first one
correlating MRD with relatively new quantitative func-
tional imaging technique — diffusion-weighted MRI
with ADC calculation.
In conclusion, quantitative PCR measurement may
detect very low level of MRD in patients with follicular
lymphoma which may have prognostic value. Combi-
nation of both PCR-based MRD and quantitative evalu-
ation of MRI-DWI derived ADC provides added-value
disease monitoring in lymphoma.
REFERENCES
1. Spagnolo DV, Ellis DW, Juneja S, et al. The role of mo-
lecular studies in lymphoma diagnosis: a review. Pathology
2004; 36: 19–44.
2. Cheson BD, Fisher RI, Barrington SF, et al. Recom-
mendations for initial evaluation, staging, and response assess-
ment of Hodgkin and non-Hodgkin lymphoma: the Lugano
Classification. J Clin Oncol 2014; 32: 3059–68.
3. Lobetti-Bodoni C, Mantoan B, Monitillo L, et al.
Clinical implications and prognostic role of minimal residual
disease detection in follicular lymphoma. Ther Adv Hematol
2013; 4: 189–98.
4. Brisco MJ, Condon J, Hughes E, et al. Outcome predic-
tion in childhood acute lymphoblastic leukaemia by molecular
quantification of residual disease at the end of induction.
Lancet 1994; 343: 196–200.
5. van der Velden VH, Hochhaus A, Cazzaniga G, et al.
Detection of minimal residual disease in hematologic mali-
gnancies by real-time quantitative PCR: principles, approa-
ches, and laboratory aspects. Leukemia 2003; 17: 1013–34.
6. Rambaldi A, Lazzari M, Carlotti E, et al. Monitoring
of minimal residual disease after CHOP and rituximab in pre-
viously untreated patients with follicular lymphoma. Blood
2002; 99: 856–62.
7. Pott C. Minimal residual disease detection in mantle
cell lymphoma: technical aspects and clinical relevance. Semin
Hematol 2011; 48: 172–84.
8. Brenner DJ, Elliston CD. Estimated radiation risks
potentially associated with full-body CT screening. Radiology
2004; 232: 735–38.
9. Kharuzhyk SA, Leusik EA. Repeated computed to-
mography examinations: radiation dose and radiation risk
in malignant lymphomas. Radiat Biol Radioecol 2014;
54: 466–73 (in Russian).
10. Vermoolen MA, Kersten MJ, Fijnheer R, et al. Mag-
netic resonance imaging of malignant lymphoma. Exp Rev
Hematol 2011; 4: 161–71.
11. Kharuzhyk SA, Zhavrid EA, Sachivko NV, et al. Possi-
bilities of whole-body diffusion-weighted magnetic resonance
imaging compared to X-ray computed tomography in staging
lymphoma. Oncol J 2015; 9: 43–8 (in Russian).
12. Punwani S, Prakash V, Bainbridge A, et al. Quantitative
diffusion weighted MRI: a functional biomarker of nodal dise-
ase in Hodgkin lymphoma? Cancer Biomark 2010; 7: 249–59.
13. Wu X, Pertovaara H, Dastidar P, et al. ADC mea-
surements in diffuse large B-cell lymphoma and follicular
lymphoma: a DWI and cellularity study. Eur J Radiol 2013;
82: e158–64.
14. Padhani AR, Liu G, Koh DM, et al. Diffusion-weighted
magnetic resonance imaging as a cancer biomarker: consensus
and recommendations. Neoplasia 2009; 11: 102–25.
15. Meleshko AN, Savva NN, Fedasenka UU, et al. Prog-
nostic value of MRD-dynamics in childhood acute lympho-
blastic leukemia treated according to the MB-2002/2008 pro-
tocols. Leuk Res 2011; 35: 1312–20.
16. Pott C, Brüggemann M, Ritgen M, et al. MRD detec-
tion in B-cell non-Hodgkin lymphomas using Ig gene rear-
rangements and chromosomal translocations as targets for real-
time quantitative PCR. Methods Mol Biol 2013; 971: 175–200.
17. Brown JR, Feng Y, Gribben JG, et al. Long-term
survival after autologous bone marrow transplantation for
follicular lymphoma in first remission. Biol Blood Marrow
Transplant 2007; 13: 1057–65.
Copyright © Experimental Oncology, 2015
|