title: Competitive CBFbeta/MYH11 reverse-transcriptase polymerase chain reaction for quantitative assessment of minimal residual disease during postremission therapy in acute myeloid leukemia with inversion(16): a pilot study.
abstract: OBJECTIVE
  (1) Quantification of minimal residual disease (MRD) by competitive CBFbeta/MYH11 reverse-transcriptase polymerase chain reaction (RT-PCR) in patients with acute myeloid leukemia (AML) and inversion(16) [inv(16)] during postremission therapy, (2) comparison of this method with conventional two-step RT-PCR, and (3) evaluation of a potential prognostic value.
  
  
  METHODS
  MRD of six consecutive adult patients with AML and inv(16)(p13;q22) or t(16;16)(p13;q22) who entered complete remission (CR) was monitored by competitive CBFbeta/MYH11 RT-PCR in their bone marrow (BM) during postremission therapy with high-dose cytarabine (HiDAC) or after BM transplantation with a matched unrelated-donor marrow (MUD-BMT) during an observation period of 4.5 to 27 months after initiation of treatment.
  
  
  RESULTS
  Competitive PCR showed a gradual decline by at least 4 orders of magnitude after 7 to 9 months in patients in continuous CR (CCR), while one patient who relapsed after 13.5 months only achieved a reduction by 2 orders of magnitude at the end of consolidation therapy. A rapid decrease below the detection limit was observed within 1 month in two patients after MUD-BMT. A temporary reappearance of molecular MRD was observed in these patients during immunosuppression for graft-versus-host disease (GvHD). After reduction of immunosuppression, the level of MRD dropped again below the PCR detection limit. Molecular monitoring by conventional two-step RT-PCR yielded comparable results only when multiple assays per time point were performed, while single-assay RT-PCR gave misleading results.
  
  
  CONCLUSIONS
  Competitive RT-PCR is a valuable tool for molecular monitoring during postremission chemotherapy, as well as after BMT.
authors.affiliation: Department of Medicine I, Clinical Institute of Medical and Chemical Laboratory Diagnosis, University of Vienna, St Anna Children's Hospital, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Laczika
authors.forename: M
authors.initials: M
authors.lastname: Novak
authors.forename: B
authors.initials: B
authors.lastname: Hilgarth
authors.forename: M
authors.initials: M
authors.lastname: Mitterbauer
authors.forename: G
authors.initials: G
authors.lastname: Mitterbauer
authors.forename: A
authors.initials: A
authors.lastname: Scheidel-Petrovic
authors.forename: C
authors.initials: C
authors.lastname: Scholten
authors.forename: R
authors.initials: R
authors.lastname: Thalhammer-Scherrer
authors.forename: S
authors.initials: S
authors.lastname: Brugger
authors.forename: F
authors.initials: F
authors.lastname: Keil
authors.forename: I
authors.initials: I
authors.lastname: Schwarzinger
authors.forename: O A
authors.initials: OA
authors.lastname: Haas
authors.forename: K
authors.initials: K
authors.lastname: Lechner
authors.forename: U
authors.initials: U
authors.lastname: Jaeger
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology*; D016026:Bone Marrow Transplantation; D007446:Chromosome Inversion; D006801:Humans; D007700:Kinetics; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D015514:Oncogene Proteins, Fusion / Q000235:genetics / Q000378:metabolism*; D010865:Pilot Projects; D016133:Polymerase Chain Reaction / Q000379:methods*; D012333:RNA, Messenger / Q000378:metabolism; D012074:Remission Induction
chemical_list: C095514:CBFbeta-MYH11 fusion protein; D015514:Oncogene Proteins, Fusion; D012333:RNA, Messenger