Impact of RT-PCR monitoring on the long-term survival in acute promyelocytic leukemia.
OBJECTIVE
To evaluate the impact of kinetics of molecular remission via retro-transcriptase polymerase chain reaction (RT-PCR) assay on the long-term survival in patients with acute promyelocytic leukemia (APL).


METHODS
Seventy patients with newly-diagnosed APL in remission were involved in this study. Monitoring of minimal residual disease (MRD) was performed regularly by RT-PCR assay for PML-RAR alpha during consolidation.


RESULTS
A 5-year relapse-free survival (RFS) and overall-survival (OS) were estimated as 46.8% +/- 8.4% and 69.9% +/- 9.4% for the whole group. Fifty-two (74.3%) patients got negative RT-PCR result at least once. Serial monitoring of RT-PCR was available in 38 cases and 24 (63.2%) patients presented with persistent negative PCR results. The achievement and continuous negative RT-PCR result was significantly related to the RFS.


CONCLUSIONS
Achievement of negative RT-PCR in remission is associated with favorable RFS and OS. Continuous negative RT-PCR results are associated with long-term relapse-free survival and may be considered as potentially curative. RT-PCR assay for detection of MRD should be performed regularly during post-remission period as an important prognostic factor.
Hu
J
J
Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Second Medical University, Ruijin Hospital-Samuel Waxman Cancer Research Foundation, Joint Center for Cancer Differentiation Therapy, Shanghai 200025, China.
Yu
T
T
Zhao
W
W
Gu
B
B
Shen
Z
Z
Li
X
X
Sun
G
G
Chen
S
S
Wang
Z
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000235:genetics / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017741:Survivors
D009363:Neoplasm Proteins; D015514:Oncogene Proteins, Fusion; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein