利用即時定量PCR方法偵測急性骨髓性白血病病人治療前後之微量殘存腫瘤細胞(2/2)
Date Issued
2002
Date
2002
Author(s)
唐季祿
DOI
902314B002244
Abstract
The 8;21 translocation is one of
common karyotype abnormalities in acute
myeloid leukemia (AML). AML1 and ETO
gene were fused in t(8;21) and can be
consistently detected by RT-PCR. In this
study, therapeutic monitoring of minimal
residual disease (MRD) using a novel,
quantitative, real-time RT-PCR was
evaluated in AML with t(8;21) as a model.
A t(8;21)-positive cell line, Kasumi-1, was
used for constructing standard curves and
the corrected AML1-ETO mRNA level
relative to the expression of the GAPDH
housekeeping gene was calculated. At
optimal condition, this assay yield an
excellent log-linear relationship of PCR
threshold cycle number (CT) with
wide-range of initial target mRNA
concentration (correlation of coefficient, r >
0.99, n=13) and sensitivity of detecting MRD as low as 10 -5 level. Sequential
measurement of AML1-ETO level was
performed in 40 t(8;21)-positive patients and
correlated with their clinical outcome. At
diagnosis, the AML1-ETO levels ranged
between 0.26~1.45-fold compared with
Kasumi-1 standard. Those patients with MRD level > 10 -2 after induction therapy and/or > 10 -3 after 1-2 courses of
consolidation therapy had higher risk of
leukemic relapse, even treated with
high-dose Ara-C or bone marrow transplant
(BMT). Those patients failed to achieve MRD level < 10 -4 within 6 months after
BMT eventually relapsed unless chronic graft-versus host disease occurred in time.
No residual MRD (i.e. less than 10 -5 ) was
detectable in 9 patients in continued
remission > 2 years. These data suggest that
this simple and sensitive assay is very useful
in therapeutic monitoring of AML treatment,
in identifying high-risk patients, and in early
detection of leukemic relapse.
Subjects
real-time PCR
quantitation
minimal residual disease
acute
myeloid leukemia
myeloid leukemia
Publisher
臺北市：國立臺灣大學醫學院內科
Type
report
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