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Evaluation of minimal residual disease using reverse-transcription polymerase chain reaction in t(8;21) acute myeloid leukemia: a multicenter study of 51 patients.
Evaluation of minimal residual disease using reverse-transcription polymerase chain reaction in t(8;21) acute myeloid leukemia: a multicenter study of 51 patients.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2000 Feb; Vol. 18 (4), pp. 788-94. - Publication Year :
- 2000
-
Abstract
- Purpose: Most studies using various reverse-transcription polymerase chain reaction (RT-PCR) techniques reported that the detection of the AML1-ETO fusion transcript was a common finding in long-term complete remission (CR) in acute myeloid leukemia (AML) with t(8;21) translocation. However, larger prospective studies with interlaboratory quality control may be important to investigate more precisely the clinical usefulness of studying minimal residual disease with RT-PCR in t(8;21) AML.<br />Patients and Methods: We collected 223 marrow samples from 51 patients with t(8;21) AML diagnosed in five centers and tested all samples by two different RT-PCR techniques (a nested technique and a one-step technique, with a sensitivity of 10(-6) and 10(-5), respectively) in two different laboratories.<br />Results: Samples from 14 patients in long persistent CR (median follow-up duration, 112 months) were taken at least twice, and all were PCR-negative by both techniques. Samples were prospectively taken from 37 patients after achievement of first CR and/or second CR, before intensive consolidation treatment, and every 3 to 6 months after completion of therapy. Patients who converted to PCR negativity with the one-step technique (60%) or both techniques (48%) after CR achievement had a longer CR duration than those with persistently positive PCR results (two-sided log-rank test, P =.0001). Patients who became PCR-negative with the one-step technique before intensive consolidation (23%) had a lower relapse rate (11% v 72%) and a longer CR duration than those who remained persistently PCR-positive at that point (two-sided log-rank test, P =.0015).<br />Conclusion: Patients with AML with t(8;21) in long-term remission were all PCR-negative. In prospectively studied patients, a good correlation was found between negative PCR results and absence of relapse. Early negative results with the one-step RT-PCR technique, before consolidation treatment, seemed to carry an especially good prognosis, suggesting that RT-PCR analysis could help in choosing the type of consolidation therapy in patients with t(8;21) AML.
- Subjects :
- Acute Disease
Adolescent
Adult
Artificial Gene Fusion
Bone Marrow Cells pathology
Child
Child, Preschool
Core Binding Factor Alpha 2 Subunit
Evaluation Studies as Topic
Female
Follow-Up Studies
Humans
Leukemia, Myeloid therapy
Linear Models
Male
Middle Aged
Neoplasm, Residual
Oncogene Proteins, Fusion genetics
Prognosis
Prospective Studies
RUNX1 Translocation Partner 1 Protein
Remission Induction
Retrospective Studies
Sensitivity and Specificity
Transcription Factors genetics
Translocation, Genetic genetics
Gene Rearrangement
Leukemia, Myeloid genetics
Polymerase Chain Reaction
Transcription, Genetic
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 18
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 10673520
- Full Text :
- https://doi.org/10.1200/JCO.2000.18.4.788