Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Laczika, K; Mitterbauer, G; Mitterbauer, M; Knöbl, P; Schwarzinger, I; Greinix, HT; Rabitsch, W; Fonatsch, C; Mannhalter, C; Lechner, K; Jaeger, U.
Prospective monitoring of minimal residual disease in acute myeloid leukemia with inversion(16) by CBFbeta/MYH11 RT-PCR: implications for a monitoring schedule and for treatment decisions.
Leuk Lymphoma. 2001; 42(5):923-931
Doi: 10.3109/10428190109097711
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- Minimal residual disease in patients with acute myeloid leukemia (AML) with inversion(16) can be monitored by CBFbeta/MYH11 RT-PCR. While the association between molecular remission (MR) in bone marrow (BM) and peripheral blood (PB) and long-term clinical remission (CR) seems to be established, there are insufficient data on the kinetics of CBFbeta/MYH11. We have performed a prospective study in order to generate a reasonable and sufficient schedule for PCR-monitoring. 11 patients with AML and inversion (16) in complete hematological remission have been prospectively monitored by CBFbeta/MYH11 RT-PCR in their BM and PB during an observation period of 7 to 67 months (median 32 months). Patients were followed during consolidation chemotherapy with repetitive cycles of high-dose Ara-C and after autologous or allogeneic stem cell transplantation in 2nd CR or refractory AML. MR never coincided with achievement of CR but occurred between 2 and 8 months after hematological remission. All patients in continuous CR were PCR-negative after 1-8 (median 4) months. Two patients relapsed despite MR for 10 to 15 months. Molecular relapse preceded hematological relapse by 3 to 5 months. Three out of four patients who were not in MR after 8 months relapsed. Allogeneic stem cell transplantation was able to eradicate minimal residual disease in 4/4 patients. In 2 patients a temporary reconversion to PCR-positivity was reversed by reduction of immunosuppression. 1 patient did not become PCR-negative until compete withdrawal of immunosuppression. We suggest that BM and PB should be examined after the last consolidation treatment. In case of MR, PB should be examined every 1 to 2 months and BM examination should be done only in case of PCR-positivity in PB in order to confirm the molecular relapse and to identify an impending cytogenetic and/or hematological relapse. CBFbeta/MYH11 RT-PCR monitoring is able to predict relapse 3 to 5 months prior to overt hematological relapse, offers a window of opportunity for preemptive therapy of molecular relapse and confers implications for immunotherapy in the setting of allografting.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Adolescent -
- Adult -
- Aged -
- Antineoplastic Combined Chemotherapy Protocols - administration & dosage
- Blood - metabolism
- Bone Marrow - metabolism
- Chromosome Inversion -
- Chromosomes, Human, Pair 16 -
- Female -
- Follow-Up Studies -
- Hematopoietic Stem Cell Transplantation -
- Humans -
- Leukemia, Myeloid - diagnosis Leukemia, Myeloid - genetics Leukemia, Myeloid - therapy
- Male -
- Middle Aged -
- Neoplasm, Residual - diagnosis Neoplasm, Residual - genetics
- Oncogene Proteins, Fusion - genetics
- Practice Guidelines as Topic -
- Prospective Studies -
- Recurrence -
- Remission Induction -
- Reverse Transcriptase Polymerase Chain Reaction -
- Find related publications in this database (Keywords)
- minimal residual disease
- AML
- inversion (16)
- CBF beta/MYH11RT-PCR
- relapse prediction
- immunotherapy