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Minimal Residual Disease in AML

Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t(8;21) and inv(16)]

Leukemia volume 20, pages 87–94 (2006)Cite this article

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/ABLx104 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 ⩽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 ⩽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.

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Acknowledgements

This study was supported by Fondo de Investigaciones Sanitarias (FIS) Grants (GO3/008 and C03/010) and XT2004/00058 from Generalitat of Catalonia. GP is a recipient of a grant of the Fundación Española de Hematología y Hemoterapia (FEHH).

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Authors and Affiliations

  1. Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    G Perea, A Lasa, A Aventín, S Brunet, J Sierra & J F Nomdedéu

  2. Hematology Department, Hospital de Bellvitge, Institut Català d’Oncologia, Hospitalet de Llobregat, Barcelona, Spain

    A Domingo & J J Berlanga

  3. Hematology Department, Hospital Clínic, Barcelona, Spain

    N Villamor

  4. Hematology Department, Hospital Virgen de la Victoria, Málaga, Spain

    M Paz Queipo de Llano

  5. Hematology Department, Hospìtal Joan XXIII, Tarragona, Spain

    A Llorente

  6. Hematology Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain

    J Juncà

  7. Hematology Department, Hospital Vall d'Hebrón, Barcelona, Spain

    C Palacios

  8. Hematology Department, Hospital Josep Trueta, Girona, Spain

    C Fernández

  9. Hematology Department, Hospital Arnau de Vilanova, Lleida, Spain

    M Gallart

  10. Hematology Department, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain

    L Font

  11. Hematology Department, Hospital Clínico, Valencia, Spain

    M Tormo

  12. Hematology Department, Hospital del Mar, Barcelona, Spain

    L Florensa

  13. Hematology Department, Hospital Son Llatzer, Mallorca, Spain

    J Bargay

  14. Hematology Department, Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain

    J M Martí

  15. Hematology Department, Clínica Teknon, Barcelona, Spain

    P Vivancos

  16. Hematology Department, Hospital Juan Canalejo, La Coruña, Spain

    P Torres

  17. Pediatrics t., Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    I Badell

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Perea, G., Lasa, A., Aventín, A. et al. Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t(8;21) and inv(16)]. Leukemia 20, 87–94 (2006). https://doi.org/10.1038/sj.leu.2404015

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