PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIA
Background and objectives: PML-RARA quantification by real time polymerase chain reaction (RQ-PCR) is an important tool for detecting minimal residual disease (MRD) in patients with acute promyelocytic leukemia (APL). We aimed to analyze the association between risk of relapse in APL patients and re...
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| Format: | Article |
| Language: | English |
| Published: |
PAGEPress Publications
2014-08-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
| Online Access: | https://mjhid.org/index.php/mjhid/article/view/1744 |
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| Summary: | Background and objectives: PML-RARA quantification by real time polymerase chain reaction (RQ-PCR) is an important tool for detecting minimal residual disease (MRD) in patients with acute promyelocytic leukemia (APL). We aimed to analyze the association between risk of relapse in APL patients and results of RQ-PCR after consolidation therapy in order to interfere with best therapeutic regimen.
Patients and Methods: Twenty one APL patients treated with PETHEMA LPA99 protocol were diagnosed by reverse transcriptase PCR (RT-PCR) method (BIOMED1 Concerted action) and evaluated by RQ-PCR (Europe against cancer program). PML-RARA transcripts after consolidation therapy were translated into normalized copy number (NCN2) and correlated with Relapse free survival (RFS).
Results: Fourteen patients (66%) achieved PML-RARA NCN2<1 (group A) while 7/21 patients (34%) had PML-RARA NCN2>1 (group B). No difference between the two groups was found regarding age, gender, hemoglobin level, platelet count, promyelocytes number in the bone marrow (BM) or serum fibrinogen level (p>0.05). Total leucocytic count (TLC) was the only significant parameter being lower in group A than group B (8 x 10 9/L versus 40 x 10 9/L) (p=0.05) and was significantly correlated with relapse-free survival (RFS) (p=0.05). Estimated RFS at 24 months in group A and B were 86% and 29%, respectively (p=0.01). Three/7 patients in group B were offered an allograft while 2 others were autografted with a molecular negative apharesis product. All 5 patients achieved a molecular remission (MR) after transplantation.
Interpretation and conclusion: RQ-PCR NCN2 results after consolidation therapy can stratify risk of relapse in APL patients and may offer a valid chance of cure by allowing an early change of therapeutic strategy. |
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| ISSN: | 2035-3006 |