title: Prognostic Significance of Mixed-Lineage Leukemia (MLL) Gene Detected by Real-Time Fluorescence Quantitative PCR Assay in Acute Myeloid Leukemia.
abstract: BACKGROUND The overall prognosis of acute myeloid leukemia (AML) patients with mixed-lineage leukemia (MLL) gene-positivity is unfavorable. In this study, we evaluated the expression levels of the MLL gene in AML patients. MATERIAL AND METHODS We enrolled 68 MLL gene-positive patients out of 433 newly diagnosed AML patients, and 216 bone marrow samples were collected. Real-time fluorescence quantitative PCR (RQ-PCR) was used to precisely detect the expression levels of the MLL gene. RESULTS We divided 41 patients into 2 groups according to the variation of MRD (minimal residual disease) level of the MLL gene. Group 1 (n=22) had a rapid reduction of MRD level to ≤10^-4 in all samples collected in the first 3 chemotherapy cycles, while group 2 (n=19) had MRD levels constantly >10^-4 in all samples collected in the first 3 chemotherapy cycles. Group 1 had a significantly better overall survival (p=0.001) and event-free survival (p=0.001) compared to group 2. Moreover, the patients with >10^-4 MRD level before the start of HSCT (hematopoietic stem cell transplantation) had worse prognosis and higher risk of relapse compared to patients with ≤10^-4 before the start of HSCT. CONCLUSIONS We found that a rapid reduction of MRD level to ≤10^-4 appears to be a prerequisite for better overall survival and event-free survival during the treatment of AML. The MRD levels detected by RQ-PCR were basically in line with the clinical outcome and may be of great importance in guiding early allogeneic HSCT (allo-HSCT) treatment.
authors: Department of Hematology, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Sai
authors: S
authors: Huang
authors: Department of Hematology, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Hua
authors: H
authors: Yang
authors: Department of Hematology, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Yan
authors: Y
authors: Li
authors: Department of Emergency Medicine, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Cong
authors: C
authors: Feng
authors: Department of Hematology, China-Japan Friendship Hospital, Hepingli, Beijing, China (mainland).
authors: Li
authors: L
authors: Gao
authors: Department of Hematology, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Guo-Feng
authors: GF
authors: Chen
authors: Department of Hematology, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Hong-Hao
authors: HH
authors: Gao
authors: Department of Electrical and Computer Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
authors: Zhi
authors: Z
authors: Huang
authors: Department of Hematology, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Yong-Hui
authors: YH
authors: Li
authors: Department of Hematology, Chinese PLA General Hospital, Beijing, China (mainland).
authors: Li
authors: L
authors: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005453:Fluorescence; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D011495:Histone-Lysine N-Methyltransferase / Q000096:biosynthesis / Q000235:genetics*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000201:enzymology / Q000235:genetics* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D051788:Myeloid-Lymphoid Leukemia Protein / Q000096:biosynthesis / Q000235:genetics*; D018365:Neoplasm, Residual; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012008:Recurrence; D059467:Transcriptome
chemical_list: C497422:KMT2A protein, human; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase