Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Mitterbauer, M; Mitterbauer-Hohendanner, G; Sperr, WR; Kalhs, P; Greinix, HT; Fonatsch, C; Haas, OA; Jäger, U; Mannhalter, C; Lechner, K.
Molecular disease eradication is a prerequisite for long-term remission in patients with t(8;21) positive acute myeloid leukemia: a single center study.
Leuk Lymphoma. 2004; 45(5): 971-977.
Doi: 10.1080/10428190310001638913
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- Association of long-term clinical remission and molecular disease-eradication is well established in acute myeloid leukemia (AML) patients with t(15;17) and inv(16). In patients with t(8;21) positive AML no consensus exists over the disappearance of the AML1/ETO fusion transcript during the course of disease and most studies reported reverse transcriptase polymerase chain reaction (RT-PCR) positivity as a common finding after consolidation chemotherapy, autologous and allogeneic stem cell transplantation (alloSCT). In our single center study, we performed RT-PCR monitoring in 14 patients with t(8;21) in CR1 (n = 13) and/or CR2 (n = 4). The median number of bone marrow (BM) and/or peripheral blood (PB) samples per patient was 18 (range, 2-43). In 5 out of 6 cases relapse occurred after persistence of minimal residual disease (MRD) in CR for 4-14 months. The sixth patient relapsed despite molecular remission (MR) in BM and PB for 3 months, molecular relapse preceded hematological relapse for 7 months. Eleven patients with a median follow-up of 7.8 (range, 1.5-15.4) years are in persistent CR and MR after consolidation chemotherapy (n = 7). mainly with repetitive cycles of high-dose Ara-C, autologous (n = 1) or myeloablative allogeneic (n = 3) stem cell transplantation. Molecular remission was attained immediately after alloSCT, but after 6-26 months in CR in patients with consolidation chemotherapy. In 7 patients, MRD was only studied in long-term remission. In conclusion, long-term CR was associated with persistent molecular disease-eradication. In our patients, molecular remission was a prerequisite but not a guarantee for long-term disease-free survival. Hematological relapse never occurred without prior molecular relapse. Due to the slow kinetics of AML1/ETO after consolidation chemotherapy the value of qualitative RT-PCR to predict early relapse is limited. In this situation quantitative RT-PCR might help to define individual relapse risk and to improve as well as facilitate clinical decision-making.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Adolescent -
- Adult -
- Chromosomes, Human, Pair 21 -
- Chromosomes, Human, Pair 8 -
- Disease-Free Survival -
- Female -
- Humans -
- Leukemia, Myeloid - diagnosis Leukemia, Myeloid - genetics Leukemia, Myeloid - mortality
- Male -
- Middle Aged -
- Neoplasm, Residual - diagnosis Neoplasm, Residual - mortality
- Predictive Value of Tests -
- Recurrence -
- Reverse Transcriptase Polymerase Chain Reaction -
- Translocation, Genetic -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- AML
- t(8
- 1)
- AML1/ETO RT-PCR
- molecular remission
- long-term disease-free survival