Early detection of minimal residual disease by reverse transcriptase polymerase chain reaction predicts relapse in acute promyelocytic leukemia

Autor: Helmut Gadner, E. Pittermann, G. Michlmayr, D. Lutz, Martin Mistrik, R. Heinz, Elisabeth Koller, Heidrun Karlic, O. Krieger
Rok vydání: 1995
Předmět:
Adult
Male
Acute promyelocytic leukemia
medicine.medical_specialty
Neoplasm
Residual
Time Factors
Receptors
Retinoic Acid
Recombinant Fusion Proteins
Molecular Sequence Data
Tretinoin
Biology
Polymerase Chain Reaction
Gastroenterology
Translocation
Genetic
law.invention
Leukemia
Promyelocytic
Acute
Predictive Value of Tests
Recurrence
law
Internal medicine
medicine
Humans
RNA
Messenger
RNA
Neoplasm
Polymerase chain reaction
DNA Primers
Chromosomes
Human
Pair 15
Hematology
Base Sequence
Retinoic Acid Receptor alpha
Remission Induction
Induction chemotherapy
Consolidation Chemotherapy
DNA
Neoplasm
General Medicine
Middle Aged
medicine.disease
Minimal residual disease
Reverse transcriptase
Reverse transcription polymerase chain reaction
Child
Preschool
Immunology
Female
DNA Probes
Chromosomes
Human
Pair 17
Zdroj: Annals of Hematology. 70:75-78
ISSN: 1432-0584
0939-5555
Popis: The PML/RAR alpha fusion RNA can be detected in acute promyelocytic leukemia (APL), cytogenetically characterized by the translocation t(15;17). Our study included ten newly diagnosed patients with APL who were investigated during the course of their diseases using reverse transcription polymerase chain reaction (RT-PCR). At diagnosis, aberrant fragments with a size heterogeneity due to alternative spliced products were detected in all patients, we observed breakpoints within bcr3 (short type) in two patients and bcr1 and 2 breakpoints (long type) in eight patients. Treatment consisted of all-trans retinoic acid (ATRA) in all patients; six patients received simultaneous cytostatic therapy during remission induction. At the time of complete hematological remission (CR), only two patients showed a negative RT-PCR result; eight of the ten patients were still PCR positive when nested primers were used. Subsequently, eight patients received consolidation chemotherapy and became PCR negative. Seven of eight patients are in continuous complete remission (median remission duration: 21 months, range: 11+ -26+ months). One patient of the chemotherapy group became PCR positive after 4 months in complete remission and relapsed after 6 months. The remaining two patients who were treated only with ATRA relapsed, received induction chemotherapy, and are in second and third complete remission, respectively. In conclusion. PCR negativity can be achieved only by chemotherapeutic consolidation; patients treated with ATRA alone remain PCR positive. Relapse is always preceded by a positive PCR result. Surprisingly, also patients without measurable PML/RAR alpha-mRNA in sequential analyses after cytostatic treatment became PCR positive and experienced relapse.
Databáze: OpenAIRE
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