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Minimal residual disease quantification in patients with acute myeloid leukaemia and inv(16)/CBFB‐MYH11 gene fusion
Author(s) -
Van Der Reijden Bert A.,
Simons Annet,
Luiten Erna,
Van Der Poel Sonja C.,
Hogenbirk Pauline E.,
Tönnissen Evelyn,
Valk Peter J. M.,
Löwenberg Bob,
De Greef Georgine E.,
Breuning Martijn H.,
Jansen Joop H.
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03738.x
Subject(s) - minimal residual disease , fusion gene , myeloid leukemia , bone marrow , chemotherapy , fusion transcript , polymerase chain reaction , real time polymerase chain reaction , medicine , gene , myeloid leukaemia , cancer research , biology , microbiology and biotechnology , immunology , genetics
Summary. We have designed a real‐time CBFB‐MYH11 reverse transcription polymerase chain reaction (RT‐PCR) assay to quantify minimal residual disease (MRD) in patients with inv(16)‐positive acute myeloid leukaemia (AML). Six patients were followed for a median of 17·5 months after diagnosis during which 120 evaluable samples were analysed. The CBFB‐MYH11 expression at diagnosis varied only fourfold between the six patients and was virtually identical to that observed in the CBFB‐MYH11‐positive cell line ME‐1. For two cases, a patient‐specific real‐time PCR for CBFB‐MYH11 quantification at genomic DNA level was designed. Similar disease levels were found at the RNA and genomic DNA level during and after treatment, indicating that CBFB‐MYH11 gene expression was unaltered during treatment and that the percentage of malignant cells can be accurately quantified at the RNA level. Following successive courses of chemotherapy, the reduction of malignant cells was found to be significantly more pronounced (80–250‐fold greater) in peripheral blood compared with bone marrow in five out of six cases tested. Treatment with gemtuzumab ozogamicin as sole agent at relapse did not result in a selective decrease of tumour cells in three cases analysed. We conclude that real‐time PCR is a powerful method of monitoring MRD levels and quantifying the antileukaemic effect of separate (experimental) courses of chemotherapy.