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...

Full description

Saved in:
Bibliographic Details
Main Author: yasser hassan elnahass
Format: Article
Language:English
Published: PAGEPress Publications 2014-08-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
Online Access:https://mjhid.org/index.php/mjhid/article/view/1744
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850283957856239616
author yasser hassan elnahass
author_facet yasser hassan elnahass
author_sort yasser hassan elnahass
collection DOAJ
description 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.
format Article
id doaj-art-e1cc3cd741464f4fa9e8a4d4bc2a5350
institution OA Journals
issn 2035-3006
language English
publishDate 2014-08-01
publisher PAGEPress Publications
record_format Article
series Mediterranean Journal of Hematology and Infectious Diseases
spelling doaj-art-e1cc3cd741464f4fa9e8a4d4bc2a53502025-08-20T01:47:40ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062014-08-011PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIAyasser hassan elnahass0National Cancer InstituteBackground 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.https://mjhid.org/index.php/mjhid/article/view/1744
spellingShingle yasser hassan elnahass
PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIA
Mediterranean Journal of Hematology and Infectious Diseases
title PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIA
title_full PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIA
title_fullStr PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIA
title_full_unstemmed PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIA
title_short PML-RARA NORMALIZED COPY NUMBER AFTER CONSOLIDATION THERAPY CAN STRATIFY THE RISK OF RELAPSE IN ADULT EGYPTIAN PATIENTS WITH ACUTE PROMYELOCYTIC LEUKEMIA
title_sort pml rara normalized copy number after consolidation therapy can stratify the risk of relapse in adult egyptian patients with acute promyelocytic leukemia
url https://mjhid.org/index.php/mjhid/article/view/1744
work_keys_str_mv AT yasserhassanelnahass pmlraranormalizedcopynumberafterconsolidationtherapycanstratifytheriskofrelapseinadultegyptianpatientswithacutepromyelocyticleukemia