Prospective long-term minimal residual disease monitoring using RQ-PCR in RUNX1-RUNX1T1-positive acute myeloid leukemia: results of the French CBF-2006 trial.
Fiche publication
Date publication
mars 2016
Journal
Haematologica
Auteurs
Membres identifiés du Cancéropôle Est :
Dr CORNILLET-LEFEBVRE Pascale
Tous les auteurs :
Willekens C, Blanchet O, Renneville A, Cornillet-Lefebvre P, Pautas C, Guieze R, Ifrah N, Dombret H, Jourdan E, Preudhomme C, Boissel N,
Lien Pubmed
Résumé
In t(8;21)(q22;q22) acute myeloid leukemia, the prognostic value of early minimal residual disease assessed with real-time quantitative polymerase chain reaction is the most important prognostic factor, but how long-term minimal residual disease monitoring may contribute to drive individual patient decisions remains poorly investigated. In the multicenter CBF-2006 study, a prospective monitoring of peripheral blood and bone marrow samples was performed every 3 months and every year, respectively, for 2 years following intensive chemotherapy in 94 patients in first complete remission. A complete molecular remission was defined as a (RUNX1-RUNX1T1/ABL1)×100 ≤ 0.001%. After the completion of consolidation therapy, a bone marrow complete molecular remission was observed in 30% of the patients, but was not predictive of subsequent relapse. Indeed, 8 patients (9%) presented a positive bone marrow minimal residual disease for up to 2 years of follow-up while still remaining in complete remission. Conversely, a peripheral blood complete molecular remission was statistically associated with a lower risk of relapse whatever the time-point considered after the completion of consolidation therapy. During the 2-year follow-up, the persistence of peripheral blood complete molecular remission was associated with a lower risk of relapse (4-year cumulative incidence, 8.2%), while molecular relapse confirmed on a subsequent peripheral blood sample predicted hematological relapse (4-year cumulative incidence, 86.9%) within a median time interval of 3.9 months. In t(8;21)(q22;q22) acute myeloid leukemia, minimal residual disease monitoring on peripheral blood every 3 months allows for the prediction of hematological relapse, and to identify patients who could potentially benefit from intervention therapy. (ClinicalTrials.gov ID #NCT00428558).
Mots clés
Adaptor Proteins, Signal Transducing, genetics, Adolescent, Adult, Antineoplastic Agents, therapeutic use, Biomarkers, Tumor, genetics, Blood Cells, metabolism, Bone Marrow, metabolism, Chromosomes, Human, Pair 22, Chromosomes, Human, Pair 8, Consolidation Chemotherapy, methods, Core Binding Factor Alpha 2 Subunit, genetics, Cytoskeletal Proteins, genetics, Female, France, Gene Expression, Humans, Leukemia, Myeloid, Acute, diagnosis, Male, Middle Aged, Monitoring, Physiologic, Neoplasm, Residual, Prospective Studies, Proto-Oncogene Proteins, genetics, Real-Time Polymerase Chain Reaction, Recurrence, Remission Induction, Survival Analysis, Transcription Factors, genetics, Translocation, Genetic
Référence
Haematologica. 2016 Mar;101(3):328-35