title: Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t(8;21) and inv(16)].
abstract: 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.
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Perea
authors.forename: A
authors.initials: A
authors.lastname: Lasa
authors.forename: A
authors.initials: A
authors.lastname: Aventín
authors.forename: A
authors.initials: A
authors.lastname: Domingo
authors.forename: N
authors.initials: N
authors.lastname: Villamor
authors.forename: M Paz
authors.initials: MP
authors.lastname: Queipo de Llano
authors.forename: A
authors.initials: A
authors.lastname: Llorente
authors.forename: J
authors.initials: J
authors.lastname: Juncà
authors.forename: C
authors.initials: C
authors.lastname: Palacios
authors.forename: C
authors.initials: C
authors.lastname: Fernández
authors.forename: M
authors.initials: M
authors.lastname: Gallart
authors.forename: L
authors.initials: L
authors.lastname: Font
authors.forename: M
authors.initials: M
authors.lastname: Tormo
authors.forename: L
authors.initials: L
authors.lastname: Florensa
authors.forename: J
authors.initials: J
authors.lastname: Bargay
authors.forename: J M
authors.initials: JM
authors.lastname: Martí
authors.forename: P
authors.initials: P
authors.lastname: Vivancos
authors.forename: P
authors.initials: P
authors.lastname: Torres
authors.forename: J J
authors.initials: JJ
authors.lastname: Berlanga
authors.forename: I
authors.initials: I
authors.lastname: Badell
authors.forename: S
authors.initials: S
authors.lastname: Brunet
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.forename: J F
authors.initials: JF
authors.lastname: Nomdedéu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D007446:Chromosome Inversion; D002885:Chromosomes, Human, Pair 16 / Q000235:genetics*; D002891:Chromosomes, Human, Pair 21 / Q000235:genetics*; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics*; D020732:Cytogenetic Analysis; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D007700:Kinetics; D007951:Leukemia, Myeloid / Q000235:genetics* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D015996:Survival Rate