Prognostic significance of the sequential detection of circulating
melanoma cells by RT-PCR in high-risk melanoma patients receiving
adjuvant interferon
The purpose of this study was to address the prognostic significance of
circulating melanoma cells by reverse transcriptase-polymerase chain
reaction in the peripheral blood of stage 1113 and III melanoma patients
on high-dose adjuvant interferon at multiple sequential time points from
initiation of treatment. Tyrosinase mRNA in peripheral blood from these
patients was assayed by reverse transcriptase polymerase chain reaction
prior to initiation of adjuvant interferon, at completion of I month of
intravenous interferon and at 3 monthly intervals until progression,
Four hundred and eighteen blood samples from 60 melanoma patients were
analysed. The median follow-up time calculated from the time of
inclusion in the study was 23 months (range 2-38 months). Tyrosinase
mRNA in blood was detected in 42 (70%) of 60 patients: 16 (76%) of 2 1
stage IIB patients and 26 (66%) of 39 stage III patients, The presence
of tyrosinase mRNA in blood was correlated with a shorter disease-free
survival (P: 0.03) and in multivariante analysis was an indepent
prognostic factor for relapse, Patients who seroconverted to a negative
reverse-transcriptase-polymerase chain reaction after induction
treatment had a significantly lower probability of recurrence, The
presence of circulating melanoma cells is a marker of a high relapse
risk and shorter disease-free survival whether detected postoperatively
or during follow-up, Tyrosinase mRNA amplification by
reverse-transcriptase-polymerase chain reaction may be a useful tool for
monitoring the efficacy of adjuvant treatment in stage IIB and III
melanoma patients, (C) 2002 Cancer Research UK
