Korean J Hematol 2003; 38(1):
Published online March 31, 2003
© The Korean Society of Hematology
AML1/ETO-양성 급성골수성백혈병에서 역전사중합효소연쇄반응을 이용한 미세잔존질환 연속측정의 의의
박경분, 이재진, 윤휘중, 김시영, 김영일, 조경삼
경희대학교 의과대학 내과학교실,
경희대학교 의과대학 동서의학연구소
Detection of Residual Leukemia with Reverse Transcription-polymerase Chain Reaction from Patients with AML1/ETO Positive Acute Myeloid Leukemia in Remission
BACKGROUND : One of the most frequent cytogenetic abnormality in acute myeloid leukemia (AML) is t(8;21) (q22;q22), with rearrangement of the AML1 gene on chromosome 21q22 and the ETO gene on chromosome 8q22. In adult AML1/ETO-associated leukemia patients, chemotherapy alone results in cure rates that are comparable to or better than those achieved with allogenic bone marrow transplantation. Despite the relatively good prognosis of AML1/ETO fusion transcript, relapse of leukemia remains the most common cause of treatment failure. Monitoring minimal residual disease (MRD) in leukemia has two main aims : to assess the effectiveness of treatment and to detect early signs of relapse. Reverse transcription-polymerase chain reaction (RT-PCR)-based methods is the rapid and sensitive method in the identification of this molecular abnormality. The purpose of this study is to ensure the usefulness of the RT-PCR technique for detecting MRD in AML1/ETO-associated leukemia patients in remission and to establish the correlation of the serial detection of AML1/ETO fusion transcripts after complete remission and long-term outcome.
METHODS : From the bone marrow aspirates of 25 AML1/ETO positive AML patients, serial detection of AML1/ETO fusion trascripts was performed using RT-PCR.
RESULTS: AML1/ETO fusion transcripts were positive in 14 cases who did not show t(8;21). In serial assay, AML1/ETO fusion transcripts was positive in 9 cases and negative in 13 cases at 10 weeks after complete remission.
AML1/ETO fusion transcripts (+) group has 107.4+/-18.2 months suvival and AML1/ETO fusion transcripts (-) group has 47.3+/-18.0 months survival. However, there is no significance (P=0.11).
CONCLUSION: This study suggests that the early negative
conversion of AML1/ETO fusion transcript may be the good prognostic predictor. The RT-PCR technique is useful for detecting minimal residual disease in leukemia patients in remission and it may improve the therapeutic strategy for leukemia.
Keywords AML1/ETO fusion transcript; RT-PCR; Acute myeloid leukemia; t(8;21);
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Korean J Hematol 2003; 38(1): 15-23
Published online March 31, 2003
Copyright © The Korean Society of Hematology.
AML1/ETO-양성 급성골수성백혈병에서 역전사중합효소연쇄반응을 이용한 미세잔존질환 연속측정의 의의
박경분, 이재진, 윤휘중, 김시영, 김영일, 조경삼
경희대학교 의과대학 내과학교실,
경희대학교 의과대학 동서의학연구소
Detection of Residual Leukemia with Reverse Transcription-polymerase Chain Reaction from Patients with AML1/ETO Positive Acute Myeloid Leukemia in Remission
Kyoung Bun Park, Jae Jin Lee, Hwi Joong Yoon, Si Young Kim, Young Il Kim, Kyung Sam Cho
Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
Department of East, West Medical Research Institute, Korea
Abstract
BACKGROUND : One of the most frequent cytogenetic abnormality in acute myeloid leukemia (AML) is t(8;21) (q22;q22), with rearrangement of the AML1 gene on chromosome 21q22 and the ETO gene on chromosome 8q22. In adult AML1/ETO-associated leukemia patients, chemotherapy alone results in cure rates that are comparable to or better than those achieved with allogenic bone marrow transplantation. Despite the relatively good prognosis of AML1/ETO fusion transcript, relapse of leukemia remains the most common cause of treatment failure. Monitoring minimal residual disease (MRD) in leukemia has two main aims : to assess the effectiveness of treatment and to detect early signs of relapse. Reverse transcription-polymerase chain reaction (RT-PCR)-based methods is the rapid and sensitive method in the identification of this molecular abnormality. The purpose of this study is to ensure the usefulness of the RT-PCR technique for detecting MRD in AML1/ETO-associated leukemia patients in remission and to establish the correlation of the serial detection of AML1/ETO fusion transcripts after complete remission and long-term outcome.
METHODS : From the bone marrow aspirates of 25 AML1/ETO positive AML patients, serial detection of AML1/ETO fusion trascripts was performed using RT-PCR.
RESULTS: AML1/ETO fusion transcripts were positive in 14 cases who did not show t(8;21). In serial assay, AML1/ETO fusion transcripts was positive in 9 cases and negative in 13 cases at 10 weeks after complete remission.
AML1/ETO fusion transcripts (+) group has 107.4+/-18.2 months suvival and AML1/ETO fusion transcripts (-) group has 47.3+/-18.0 months survival. However, there is no significance (P=0.11).
CONCLUSION: This study suggests that the early negative
conversion of AML1/ETO fusion transcript may be the good prognostic predictor. The RT-PCR technique is useful for detecting minimal residual disease in leukemia patients in remission and it may improve the therapeutic strategy for leukemia.
Keywords: AML1/ETO fusion transcript, RT-PCR, Acute myeloid leukemia, t(8,21),
