학술논문

A multigene array for measurable residual disease detection in AML patients undergoing SCT.
Document Type
Article
Source
Bone Marrow Transplantation. May2015, Vol. 50 Issue 5, p642-651. 10p. 1 Diagram, 4 Charts, 2 Graphs.
Subject
*ACUTE myeloid leukemia
*GENETIC disorders
*TRANSPLANTATION of organs, tissues, etc.
*GENE expression
*BIOMARKERS
*PATIENTS
Language
ISSN
0268-3369
Abstract
AML is a diagnosis encompassing a diverse group of myeloid malignancies. Heterogeneous genetic etiology, together with the potential for oligoclonality within the individual patient, have made the identification of a single high-sensitivity marker of disease burden challenging. We developed a multiple gene measurable residual disease (MG-MRD) RQ-PCR array for the high-sensitivity detection of AML, retrospectively tested on 74 patients who underwent allo-SCT at the NHLBI in the period 1994-2012. MG-MRD testing on peripheral blood samples prior to transplantation demonstrated excellent concordance with traditional BM-based evaluation and improved risk stratification for post-transplant relapse and OS outcomes. Pre-SCT assessment by MG-MRD predicted all clinical relapses occurring in the first 100 days after allo-SCT compared with 57% sensitivity using WT1 RQ-PCR alone. Nine patients who were negative for WT1 prior to transplantation were correctly reclassified into a high-risk MG-MRD-positive group, associated with 100% post-transplant mortality. This study provides proof of principle that a multiple gene approach may be superior to the use of WT1 expression alone for AML residual disease detection. [ABSTRACT FROM AUTHOR]