Monitoring of Residual Disease in Adult Acute Lymphoblastic Leukemia: Towards Personalized Medicine
- سال انتشار: 1397
- محل انتشار: سومین کنگره بین المللی و پانزدهمین کنگره ملی ژنتیک ایران
- کد COI اختصاصی: CIGS15_445
- زبان مقاله: انگلیسی
- تعداد مشاهده: 306
نویسندگان
Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
چکیده
Background: Ig/TCR receptor rearrangements QPCR technology is considered as a powerful method for minimal residual disease (MRD) detection in Acute Lymphoblastic Leukemia (ALL). In the present study, we evaluated an ASO (Allele Specific Oligonucleotide)-qPCR assay for MRD detection in adult ALL patients.Methods: Ninety-eight newly diagnosed ALL patients were enrolled in this study. V/J-usage was first identified in each diagnostic sample. Specific primers were designed based on unique sequence of hyper-variable regions in each patient. 2.5-year monthly MRD quantification was performed using ASO-qPCR method, for detection and screening of patient-specific Ig/TCR receptor rearrangements. Results: From 98 ALL patients, 72 were enrolled in our study for MRD screening. Clonal Ig/TCR gene rearrangements were detected in each patient. MRD detection was performed with one-month interval time in each case. Regarding the MRD threshold, patients were classified into two distinct groups of low-risk and high-risk. It was found that 2.5-year overall survival was significantly lower in high-risk group. Multivariate analysis showed that MRD-level at day 28 of induction therapy and onwards are the only significant prognostic factor. Clinical relapse was predictable in relapsed cases. Discussion: ASO-qPCR is a sensitive method for MRD detection. Patient classification and identification of those with a high-risk of relapse would be possible with MRD monitoring. MRD-levels at the end of induction therapy up to day 88 of therapy showed a strong association with patients’ outcome. MRD-based risk assessment is a precise approach which leads to personalized medicine in adult ALL through accurate risk group assignment with risk-adapted therapy.کلیدواژه ها
Minimal residual disease, adult acute lymphoblastic leukemia, ASO-qPCR, Ig/TCR gene rearrangement, personalized medicineمقالات مرتبط جدید
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