DEK-CAN molecular monitoring of myeloid malignancies could aid therapeutic stratification.
The t(6;9)(p23;q34) is a recurrent chromosomal abnormality observed in 1% of acute myelogenous leukemia (AML), which generates a fusion transcript between DEK and CAN/NUP214 genes. We used a DEK-CAN real-time quantitative (RQ)-PCR strategy to analyze 79 retrospective and prospective samples from 12 patients. Five patients reached DEK-CAN negativity (sensitivity 10(-5)); all underwent early allogeneic hematopoietic stem cell transplantation (median 5.5 months from diagnosis) with some demonstrating molecular positivity at the time of allograft. All four cases in CCR with adequate follow-up (median 18.5 months, range 13--95) demonstrate persistent molecular negativity, whereas all seven patients with persistent DEK-CAN positivity died at a median of 12 months from diagnosis (range 7--27). We conclude that DEK-CAN molecular monitoring by RQ-PCR in t(6;9) malignancies is a useful tool for individual patient management and that molecular negativity is indispensable for survival, but should not be a prerequisite for allografting in this rare, poor prognosis, subset of AML.
Faculté de Medecine, Université Paris-Descartes, INSERM EMI U210 and AP-HP Hématologie-biologique, Hôpital Necker- Enfants Malades, rue de Sèvres, Paris cedex, France.
L
L
Garçon
M
M
Libura
E
E
Delabesse
F
F
Valensi
V
V
Asnafi
C
C
Berger
C
C
Schmitt
T
T
Leblanc
A
A
Buzyn
E
E
Macintyre
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D015513:Oncogene Proteins / Q000032:analysis* / Q000235:genetics; D015514:Oncogene Proteins, Fusion / Q000032:analysis / Q000235:genetics; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011993:Recombinant Fusion Proteins / Q000032:analysis* / Q000235:genetics; D015996:Survival Rate
C104001:DEK-CAN fusion protein, recombinant; D015513:Oncogene Proteins; D015514:Oncogene Proteins, Fusion; D011993:Recombinant Fusion Proteins