1. Nucleophosmin gene-based monitoring inde novocytogenetically normal acute myeloid leukemia with nucleophosmin gene mutations: comparison with cytofluorimetric analysis and study of Wilms tumor gene 1 expression
- Author
-
Nicoletta Colombo, Chiara Ghiggi, Marco De Gobbi, Raffaella Grasso, Paola Minetto, Carlo Marani, Fabio Guolo, Filippo Ballerini, Angelo Michele Carella, Marino Clavio, Gian Matteo Pica, Maurizio Miglino, Miglino, M, Colombo, N, Grasso, R, Marani, C, Clavio, M, Pica, G, Ballerini, F, Ghiggi, C, Minetto, P, Guolo, F, Carella, A, and Gobbi, M
- Subjects
Adult ,Oncology ,Cancer Research ,medicine.medical_specialty ,Pathology ,Genes, Wilms Tumor ,Neoplasm, Residual ,NPM ,Gene mutation ,medicine.disease_cause ,Disease-Free Survival ,Immunophenotyping ,AML ,genetics, Leukemia ,Internal medicine ,medicine ,Humans ,genetics ,Gene ,Aged ,Nucleophosmin ,Mutation ,Leukemia ,integumentary system ,business.industry ,Nuclear Proteins ,Myeloid leukemia ,Wilms' tumor ,Hematology ,Middle Aged ,Flow Cytometry ,medicine.disease ,Minimal residual disease ,WT1 ,Leukemia, Myeloid, Acute ,MRD ,business - Abstract
We compared the clinical value of minimal residual disease (MRD) monitoring by cytofluorimetric methods, Wilms tumor gene 1 (WT1) expression and the study of nucleophosmin gene (NPM) mutations in a series of 26 patients with NPM-mutated de novo acute myeloid leukemia (NPM-AML) who achieved complete hematological remission after conventional chemotherapy. The relapse risk was significantly lower only in patients achieving a NPM molecular complete response (NPM mol-CR) and confirmed NPM mol-CR (non-detectable NPM mutations in two consecutive marrow samples). The disease-free survival (DFS) of patients achieving a = 4-log reduction in NPM value after induction therapy was 12.6 % and 50%, respectively, at 36 months (p = 0.009). The attainment of a confirmed NPM-CR had a significant influence on overall survival (OS at 36 months was 64.3% and 11.9% in patients obtaining or not obtaining confirmed NPM-CR, respectively, p < 0.03). We confirm that NPM-molecular relapse (NPM-rel) is always followed by hematological relapse (H-rel), but longitudinal studies of NPM mutations may predict an impending H-rel earlier than flow cytometric- or WT1-based methods.
- Published
- 2012
- Full Text
- View/download PDF