Real-time PCR analysis of PML-RAR alpha in newly diagnosed acute promyelocytic leukaemia patients treated with arsenic trioxide as a front-line therapy.

Ghaffari, S H; Rostami, S; Bashash, D; Alimoghaddam, K; Ghavamzadeh, A

Ghaffari, S H; Rostami, S; Bashash, D; Alimoghaddam, K; Ghavamzadeh, A.

Afiliación

Ghaffari SH; Hematology, Oncology and BMT Research Center, Tehran University Medical Sciences, Shariaty Hospital, Tehran, Iran. shghaffari2000@yahoo.com

Ann Oncol ; 17(10): 1553-9, 2006 Oct.

Article en En | MEDLINE | ID: mdl-16831853

RESUMEN

BACKGROUND: Recently, patients with acute promyelocytic leukaemia (APL) have experienced significant clinical gains after treatment with arsenic trioxide. However, the use of this agent as a front-line therapy for newly diagnosed patients is unclear. PATIENTS AND METHODS: Of 95 newly diagnosed APL patients, 85 patients who achieved complete remission (CR) were sequentially evaluated during a 4-60 month period by conventional RT-PCR. A total of 30 patients (six relapsed and 24 in continued CR) were selected and monitored by quantitative real-time PCR (RQ-PCR) assay. The PML-RARalpha fusion transcripts values were normalised to every 10(6) copies of G6PDH transcripts (NQ). RESULTS: RQ-PCR analyses showed a rapid rate of clearance of NQ levels during the courses of arsenic therapy. In the majority of patients in CR, the NQ levels were below 5 x 10(2) in peripheral blood (PB) samples. In all the relapsed cases with follow-up intervals of 1-6 months (median 3 months) clinical relapse was predictable by increasing NQ level above this threshold. CONCLUSIONS: Our study highlights the usefulness of PB and the definition of threshold level for early prediction of relapse. The threshold level correlates well with risk of relapse; therefore, transcript ratio below the level should be regarded as a goal in the clinical management of this disease.

Asunto(s)

Arsenicales/uso terapéutico; Leucemia Promielocítica Aguda/tratamiento farmacológico; Proteínas de Fusión Oncogénica/análisis; Óxidos/uso terapéutico; Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos; Adolescente; Adulto; Anciano; Antineoplásicos/uso terapéutico; Trióxido de Arsénico; Biomarcadores de Tumor/análisis; Biomarcadores de Tumor/metabolismo; Niño; Diagnóstico Precoz; Femenino; Estudios de Seguimiento; Expresión Génica/efectos de los fármacos; Glucosafosfato Deshidrogenasa/metabolismo; Humanos; Leucemia Promielocítica Aguda/metabolismo; Leucemia Promielocítica Aguda/patología; Masculino; Persona de Mediana Edad; Análisis Multivariante; Terapia Neoadyuvante/métodos; Proteínas de Fusión Oncogénica/metabolismo; Isoformas de Proteínas/análisis; Isoformas de Proteínas/metabolismo; Proteínas Recombinantes de Fusión/análisis; Proteínas Recombinantes de Fusión/metabolismo; Recurrencia

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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Óxidos / Arsenicales / Leucemia Promielocítica Aguda / Proteínas de Fusión Oncogénica / Reacción en Cadena de la Polimerasa de Transcriptasa Inversa Tipo de estudio: Diagnostic_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Oncol Asunto de la revista: NEOPLASIAS Año: 2006 Tipo del documento: Article País de afiliación: Irán Pais de publicación: Reino Unido

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