Journal Article

Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics t(8;21) and inv(16)

Bargay, J, Villamor, N, Juncà, J, Font, L, Lasa, A, Martí, J M, Perea, G, Domingo, A, Tormo, M, Aventín, A, Fernández, C, Badell, I, Berlanga, J J, Sierra, J, Paz Queipo de Llano, M, Florensa, L, Torres, P, Brunet, S, Vivancos, P, Palacios, C, Llorente, A, Gallart, M, Nomdedéu, J F

2006

Overview

Most patients with acute myeloid leukemia (AML) and t(8;21) or inv(16) have a good prognosis with current anthracycline- and cytarabine-based protocols. Tandem analysis with flow cytometry (FC) and real-time RT-PCR (RQ-PCR) was applied to 55 patients, 28 harboring a t(8;21) and 27 an inv(16), including one case with a novel CBFbeta/MYH11 transcript. A total of 31% (n=17) of CR patients relapsed: seven with t(8;21) and 10 with inv(16). The mean amount of minimal residual disease (MRD) detected by FC in relapsed and nonrelapsed patients was markedly different: 0.3 vs 0.08% (P=0.002) at the end of treatment. The mean number of fusion transcript copies/ ABL x 10(4) also differed between relapsed and non-relapsed patients: 2385 vs 122 (P=0.001) after induction, 56 vs 7.6 after intensification (P=0.0001) and 75 vs 3.3 (P=0.0001) at the end of chemotherapy. Relapses were more common in patients with FC MRD level >0.1% at the end of treatment than in patients with < or = 0.1%: cumulative incidence of relapse (CIR) was 67 and 21% (P=0.03), respectively. Likewise, using RQ-PCR, a cutoff level of >10 copies at the end of treatment correlated with a high risk of relapse: CIR was 75% for patients with RQ-PCR >10 compared to 21% for patients with RQ-PCR levels < or = 10 (P=0.04). Combined use of FC and RQ-PCR may improve MRD detection, and provide useful clinical information on relapse kinetics in AML patients.

• Publisher: Nature Publishing Group
• Subject: Acute Disease / Adolescent / Adult / Aged / Bone marrow / Chemotherapy / Child / Child, Preschool / Chromosome Inversion / Chromosomes, Human, Pair 16 - genetics / Chromosomes, Human, Pair 21 - genetics / Chromosomes, Human, Pair 8 - genetics / Cytogenetic Analysis / Cytogenetics / Female / Flow Cytometry / Follow-Up Studies / Humans / Kinetics / Leukemia / Leukemia, Myeloid - genetics / Leukemia, Myeloid - metabolism / Leukemia, Myeloid - therapy / Male / Middle Aged / Neoplasm, Residual - diagnosis / Neoplasm, Residual - genetics / Neoplasm, Residual - therapy / Prognosis / Recurrence / Remission (Medicine) / Reverse Transcriptase Polymerase Chain Reaction / Risk Factors / Survival Rate