Minimal residual disease (MRD) monitoring and mutational landscape in AML with RUNX1-RUNX1T1: a study on 134 patients

Höllein, Alexander; Jeromin, Sabine; Meggendorfer, Manja; Fasan, Annette; Nadarajah, Niroshan; Kern, Wolfgang; Haferlach, Claudia; Haferlach, Torsten

doi:10.1038/s41375-018-0086-0

“…However, relapse is currently the main factor affecting the survival of pediatric t(8;21) AML patients, which is a problem that needs addressing. Many studies have demonstrated that MRD monitoring using RQ-PCR can effectively identify patients with higher risk of relapse [6,10,11], however, the most powerful timing and checkpoints for MRD monitoring were unclear. John A. et al demonstrated that after course 3, the 2 most prognostic factors for relapse risk were 4 log reduction in BM and BM copy number > 500 [7].…”

Section: Discussionmentioning

confidence: 99%

Allogeneic hematopoietic stem cell transplantation can improve the prognosis of high-risk pediatric t(8;21) acute myeloid leukemia in first remission based on MRD-guided treatment

Hu

¹

,

Cheng

²

,

Lu

³

et al. 2020

View full text Add to dashboard Cite

Background: Pediatric acute myeloid leukemia (AML) with t(8;21) (q22;q22) is classified as a low-risk group. However, relapse is still the main factor affecting survival. We aimed to investigate the effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on reducing recurrence and improving the survival of high-risk pediatric t(8;21) AML based on minimal residual disease (MRD)-guided treatment, and to further explore the prognostic factors to guide risk stratification treatment and identify who will benefit from allo-HSCT. Methods: Overall, 129 newly diagnosed pediatric t(8;21) AML patients were included in this study. Patients were divided into high-risk and low-risk group according to RUNX1-RUNX1T1 transcript levels after 2 cycles of consolidation chemotherapy. High-risk patients were divided into HSCT group and chemotherapy group according to their treatment choices. The characteristics and outcomes of 125 patients were analyzed.

show abstract

“…We recently identified 94 patients that were diagnosed between 2005 and 2017 with AML with RUNX1-RUNX1T1 fusion and achieved MR following intensive treatment. 8 The twenty-one out of ninety-four patients relapsed despite this good risk situation. There was no significant difference in clinical parameters upfront in patients who relapsed following MR compared to patients who did not relapse (Table 1).…”

Section: Resultsmentioning

confidence: 96%

Molecular characterization of AML with RUNX1‐RUNX1T1 at diagnosis and relapse reveals net loss of co‐mutations

Höllein

¹

,

Nadarajah

²

,

Meggendorfer

³

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, relapse is currently the main factor affecting the survival of paediatric t(8;21) AML patients, which is a problem that needs to be addressed. Many studies have demonstrated that MRD monitoring using RQ-PCR can effectively identify patients with higher risk of relapse [6,11,12]; however, the most powerful timing and checkpoints for MRD monitoring are unclear. Yin et al demonstrated that after course 3, the two most prognostic factors for relapse risk were 4 log reduction in BM and BM copy number > 500 [7].…”

Section: Discussionmentioning

confidence: 99%

Allogeneic haematopoietic stem cell transplantation can improve the prognosis of high-risk paediatric t(8;21) acute myeloid leukaemia in first remission based on MRD-guided treatment.

Hu

¹

,

Cheng

²

,

Lu

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Pediatric acute myeloid leukemia (AML) with t(8;21) (q22;q22) is classified as a low-risk group. However, relapse is still the main factor affecting survival. We aimed to investigate the effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on reducing recurrence and improving the survival of high-risk pediatric t(8;21) AML based on minimal residual disease (MRD)-guided treatment, and to further explore the prognostic factors to guide risk stratification treatment and identify who will benefit from allo-HSCT. Methods: Overall, 129 newly diagnosed pediatric t(8;21) AML patients were included in this study. Patients were divided into high-risk and low-risk group according to RUNX1-RUNX1T1 transcript levels after two cycles of consolidation chemotherapy. High-risk patients were divided into HSCT group and chemotherapy group according to their treatment choices. The characteristics and outcomes of 125 patients were analyzed. Results: For high-risk patients, allo-HSCT could improve 5-year relapse-free survival (RFS) rate compared to chemotherapy (87.4% vs. 61.9%; P = 0.026). Five-year overall survival (OS) rate in high-risk HSCT group had a trend for better than that in high-risk chemotherapy group (82.8% vs. 71.4%; P = 0.260). The 5-year RFS rate of patients with a c-KIT mutation in high-risk HSCT group had a trend for better than that of patients with a c-KIT mutation in high-risk chemotherapy group (82.9% vs. 75%; P = 0.400). Extramedullary infiltration (EI) at diagnosis was associated with a high cumulative incidence of relapse for high-risk patients (50% vs. 18.4%; P = 0.004); allo-HSCT can improve the RFS (P = 0.009). Conclusions: allo-HSCT can improve the prognosis of high-risk pediatric t(8;21) AML based on MRD-guided treatment. Patients with a c-KIT mutation may benefit from allo-HSCT. EI is an independent prognostic factor for high-risk patients and allo-HSCT can improve the prognosis.

show abstract

Minimal residual disease (MRD) monitoring and mutational landscape in AML with RUNX1-RUNX1T1: a study on 134 patients

Cited by 23 publications

References 14 publications

Allogeneic hematopoietic stem cell transplantation can improve the prognosis of high-risk pediatric t(8;21) acute myeloid leukemia in first remission based on MRD-guided treatment

Allogeneic hematopoietic stem cell transplantation can improve the prognosis of high-risk pediatric t(8;21) acute myeloid leukemia in first remission based on MRD-guided treatment

Molecular characterization of AML with RUNX1‐RUNX1T1 at diagnosis and relapse reveals net loss of co‐mutations

Allogeneic haematopoietic stem cell transplantation can improve the prognosis of high-risk paediatric t(8;21) acute myeloid leukaemia in first remission based on MRD-guided treatment.

Contact Info

Product

Resources

About