Tobal K, Yin J A
University Department of Haematology, Manchester Royal Infirmary, UK.
Blood. 1996 Nov 15;88(10):3704-9.
We have developed a quantitative reverse transcriptase-polymerase chain reaction method for the quantitation of AML1-MTG8 transcripts in patients with AML-M2 and t(8;21) in different phases of the disease. Using this method, we have tested sequential samples from 13 patients to monitor minimal residual disease and were able to show a significant increase in AML1-MTG8 transcripts level in two patients 2 and 4 months before clinical relapse. In five patients tested at presentation and then sequentially at remission, we detected a marked decrease in the level of AML1-MTG8 transcripts as the treatment progressed. Patients in long-term remission of their disease had a level of up to 1 x 10(3) AML1-MTG8 molecules/microgram RNA. Two patients tested 2 and 4 months before hematologic relapse showed a level of 0.71 x 10(5) molecules/microgram RNA and this level increased further during relapse to 0.71 x 10(7) and 2.27 x 10(5) molecules/microgram RNA, respectively. Our results show that quantitation of AML1-MTG8 transcripts by competitive polymerase chain reaction is valuable in predicting early relapse in AML with t(8;21). Identification of at-risk patients may allow treatment to be modified to include additional or alternative therapy such as bone marrow transplantation.
我们开发了一种定量逆转录酶-聚合酶链反应方法，用于定量分析急性髓细胞白血病M2型伴t(8;21)患者在疾病不同阶段的AML1-MTG8转录本。使用该方法，我们检测了13例患者的系列样本以监测微小残留病，并能够显示在2例患者临床复发前2个月和4个月时AML1-MTG8转录本水平显著升高。在5例初诊时检测然后在缓解期序贯检测的患者中，我们发现随着治疗进展AML1-MTG8转录本水平显著下降。疾病长期缓解的患者AML1-MTG8分子水平高达1×10³/微克RNA。2例在血液学复发前2个月和4个月检测的患者显示水平分别为0.71×10⁵分子/微克RNA，且在复发期间该水平进一步升高至0.71×10⁷和2.27×10⁵分子/微克RNA。我们的结果表明，通过竞争性聚合酶链反应定量AML1-MTG8转录本对于预测伴t(8;21)的急性髓细胞白血病早期复发具有重要价值。识别高危患者可能有助于调整治疗方案，纳入额外或替代治疗，如骨髓移植。
