title: [Prognostic value of dynamic monitoring of RUNX1-RUNX1T1 transcript in pediatric acute myeloid leukemia].
abstract: Objective:To investigate the prognostic value of dynamic monitoring of RUNX1-RUNX1T1 transcript in pediatric patients with t (8;21) acute myeloid leukemia (AML) .Methods:The clinical features and RUNX1-RUNX1T1 transcript levels of 55 pediatric t (8;21) AML patients, newly diagnosed from Jan. 2010 to Apr. 2016, were analyzed retrospectively. The relationship between the minimal residual disease (MRD) and prognosis was analysed by dynamic monitoring of RUNX1-RUNX1T1 transcript levels using real-time quantitative PCR (RQ-PCR) technology.Results:The RUNX1-RUNX1T1 transcript levels in bone marrow cells at diagnosis was not related to relapse. After one course of induction therapy, patients with a more than 2 Log reduction of RUNX1-RUNX1T1 transcript levels (>2 Log) had lower 5 years cumulative incidence of relapse (CIR) [ (24.3±8.4) %vs(52.6±9.7) %,χ(2)=9.046,P=0.003], relapse-free survival (RFS) [ (71.6±12.7) %vs(48.1±13.2) %,χ(2)=5.814,P=0.016], and better overall survival (OS) [ (76.9±12.5) %vs(48.9±14.7) %,χ(2)=6.346,P=0.012], compared to patients with a less than 2 Log reduction (a<2 Log) . Multivariate Cox survival analysis suggested that a>2 Log reduction in RUNX1-RUNX1T1 transcript levels after a course of induction therapy was an independent prognostic factor for RFS (HR=0.263, 95%CI0.081-0.851,P=0.026) and OS (HR=0.214, 95%CI0.057-0.808,P=0.023) . During consolidation therapy and follow-up period, molecular relapse of 16 cases and hematologic relapse of 13 cases were identified by continuous dynamic monitoring of RUNX1-RUNX1T1 transcript levels, with a median interval of 4.0 (1.5-5.8) months from the molecular relapse to hematologic relapse. 2 cases of molecular relapse who received timely allogeneic hematopoietic stem cell transplantation did not experience hematologic relapse.Conclusion:Dynamic monitoring RUNX1-RUNX1T1 transcript levels by RQ-PCR technique can subdivide patients into relatively low and high risk group, early screen patients at high risk of relapse and provide a scientific basis for precision stratification and risk-adapted therapy for pediatric t (8;21) AML children.
authors.affiliation: Department of Hematology, Zhengzhou University People's Hospital, Zhengzhou 450003, China.
authors.forename: H T
authors.initials: HT
authors.lastname: Gao
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: K
authors.initials: K
authors.lastname: Sun
authors.forename: J M
authors.initials: JM
authors.lastname: Guo
authors.forename: Y Q
authors.initials: YQ
authors.lastname: Chen
authors.forename: X L
authors.initials: XL
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Shi
authors.forename: X N
authors.initials: XN
authors.lastname: Niu
authors.forename: F
authors.initials: F
authors.lastname: Wang
authors.forename: L
authors.initials: L
authors.lastname: Huo
mesh_terms: D002648:Child; D002898:Chromosomes, Human, Pair 8; D050676:Core Binding Factor Alpha 2 Subunit; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute; D018365:Neoplasm, Residual; D011379:Prognosis; D000075142:RUNX1 Translocation Partner 1 Protein; D060888:Real-Time Polymerase Chain Reaction; D012008:Recurrence; D012189:Retrospective Studies; D014178:Translocation, Genetic
chemical_list: D050676:Core Binding Factor Alpha 2 Subunit; D000075142:RUNX1 Translocation Partner 1 Protein; C493728:RUNX1 protein, human; C082222:RUNX1T1 protein, human
keywords: Child; Gene fusion, RUNX1-RUNX1T1; Leukemia, myeloid, acute; Neoplasm, residual; Prognosis