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Monitoring of minimal residual disease in acute myeloid leukemia with t(8;21)(q22;q22)

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Abstract

The fusion gene AML1/ETO is a molecular marker for monitoring minimal residual disease (MRD) in acute myeloid leukemia with the t(8;21)(q22;q22) translocation. To evaluate the dynamic variation and prognostic significance of AML1/ETO, bone marrow samples from 52 patients at different periods were examined qualitatively (32 patients) or quantitatively (20 patients) using nested RT-PCR and RQ-PCR, respectively. In the qualitative group, AML1/ETO in 71.88 and 95.45 % patients became negative at six and 24 months after CR, respectively. Patients in long-term remission were all RT-PCR-negative. Patients negative for AML1/ETO at 6–12 months and 12–18 months after CR had lower relapse rate (P = 0.003 and 0.000), higher relapse-free survival (RFS) (P = 0.000 and 0.000), and overall survival (P = 0.001 and 0.000) than patients with positive AML1/ETO. Quantitative analysis showed that there was no trend where higher relapse rate occurred in patients with higher levels of AML1/ETO transcripts at diagnosis (P > 0.05). Patients whose AML1/ETO transcripts decreased by more than 2 log at CR had higher RFS (P = 0.02). At the checkpoints of 3 and 5/6 months after CR, patients with lower AML1/ETO copy numbers showed lower probability of relapse (P = 0.039 and 0.004). An increase of AML1/ETO transcripts (0.5 log) at any time after CR indicated increased risk of relapse (P = 0.002). Our study shows that both qualitative and quantitative detection of AML1/ETO have prognostic value in MRD monitoring. Negative or continuous low expression of AML1/ETO indicates increased disease-free survival.

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Acknowledgments

This study was supported by the National Public Health Benefit Research Foundation (NO.201202017) and the Important National Science & Technology Specific Projects (NO.2011ZX09302-007-04) of China.

Conflict of interest

The authors do not have any conflict of interest to disclose.

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Authors and Affiliations

  1. State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, People’s Republic of China

    Lixia Zhang, Qinghua Li, Wei Li, Bingcheng Liu, Ying Wang, Dong Lin, Chunlin Zhou, Chengwen Li, Jianxiang Wang & Yingchang Mi

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  1. Lixia Zhang
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  2. Qinghua Li
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  3. Wei Li
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  4. Bingcheng Liu
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  6. Dong Lin
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  7. Chunlin Zhou
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  8. Chengwen Li
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  9. Jianxiang Wang
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  10. Yingchang Mi
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Correspondence to Yingchang Mi.

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Zhang, L., Li, Q., Li, W. et al. Monitoring of minimal residual disease in acute myeloid leukemia with t(8;21)(q22;q22). Int J Hematol 97, 786–792 (2013). https://doi.org/10.1007/s12185-013-1344-6

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  • DOI: https://doi.org/10.1007/s12185-013-1344-6

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