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学科主题: 临床医学
题名:
Monitoring Mixed Lineage Leukemia Expression May Help Identify Patients with Mixed Lineage Leukemia-Rearranged Acute Leukemia Who Are at High Risk of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation
作者: Liu, Jing1; Wang, Yu1; Xu, Lan-Ping1; Liu, Dai-Hong1; Qin, Ya-Zhen1; Chang, Ying-Jun1; Liu, Kai-Yan1; Huang, Xiao-Jun1,2
关键词: Minimal residual disease ; Mixed lineage leukemia (MLL) ; acute leukemia ; Allogeneic hematopoietic stem cell transplantation
刊名: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
发表日期: 2014-07-01
DOI: 10.1016/j.bbmt.2014.03.008
卷: 20, 期:7, 页:929-936
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Hematology ; Immunology ; Transplantation
研究领域[WOS]: Hematology ; Immunology ; Transplantation
关键词[WOS]: ACUTE MYELOID-LEUKEMIA ; ACUTE LYMPHOBLASTIC-LEUKEMIA ; MINIMAL RESIDUAL DISEASE ; POLYMERASE-CHAIN-REACTION ; MLL GENE ; MARROW-TRANSPLANTATION ; PERIPHERAL-BLOOD ; CANCER PROGRAM ; ADULT PATIENTS ; BONE-MARROW
英文摘要:

To evaluate the prognostic value of the expression of the mixed lineage leukemia (MLL) gene for predicting the relapse of patients with MLL-rearranged acute leukemia (AL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT), the levels of MLL transcripts in bone marrow (BM) specimens were monitored serially by real-time quantitative polymerase chain reaction (RQ-PCR) at predetermined time points in 40 patients with MLL-rearranged AL who were treated with allo-HSCT. These patients were followed for a median of 24.5 months (range, 8 to 60 months). A total of 236 BM samples were collected and analyzed. Of these, 230 were monitored concurrently for minimal residual disease (MRD) by flow cytometry (FCM) for leukemia-associated aberrant immune phenotypes and by RQ-PCR for the expression of the Wilms tumor (WT1) gene. The 3-year cumulative incidence of relapse in patients who experienced MLL-positive patients (MLL > .0000%) (n = 9) after HSCT was 93.5% (95% confidence interval [CI], 87% to 100%) compared with 12.5% (95% CI, 5.6% to 19.4%) for MLL-negative patients (n = 31) (P < .001). For these 2 patient groups, the 3-year overall survival (OS) was 12.5% (95% CI, .8% to 24.2%) and 77.8% (95% CI, 68.4% to 87.2%) (P < .001), respectively, and the 3-year leukemia-free survival (LFS) was 0% and 72.2% (95% CI, 61.1% to 83.3%), respectively (P < .001). MLL positivity was associated with a higher rate of relapse (hazard ratio [HR], 18.643; 95% CI, 3.449 to 57.025; P = .001), lower LFS (HR, 7.267; 95% CI, 2.038 to 25.916; P = .002), and lower OS (HR, 8.259; 95% CI, 2.109 to 32.336; P = .002), as determined by Cox multivariate analysis. The expression of the MLL gene had a higher specificity and sensitivity than WT1 or MRD monitored by FCM for predicting the relapse of the patients with MLL + AL. Our results suggest that monitoring the expression of the MLL gene may help to identify patients with MLL + AL who are at high risk of relapse after allo-HSCT and may provide a guide for suitable intervention. (C) 2014 American Society for Blood and Marrow Transplantation.

语种: 英语
所属项目编号: 81230013 ; Z111107067311070 ; SS2013AA020104
项目资助者: National Natural Science Foundation of China ; Beijing Municipal Science and Technology Program ; National High-Technology Research and Development Program (863 Program) of China
WOS记录号: WOS:000337850500005
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/53356
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: 1.Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China
2.Peking Univ, Peoples Hosp, Peking Univ Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing 100044, Peoples R China

Recommended Citation:
Liu, Jing,Wang, Yu,Xu, Lan-Ping,et al. Monitoring Mixed Lineage Leukemia Expression May Help Identify Patients with Mixed Lineage Leukemia-Rearranged Acute Leukemia Who Are at High Risk of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation[J]. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION,2014,20(7):929-936.
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