Prognostic value of AML1/ETO fusion transcripts in patients with acute myelogenous leukemia.
- Author:
Eun Kyung CHO
1
;
Eun Kyung JUNG
;
Jeong Yeal AHN
;
Do Yoon LIM
;
Sun Young KYUNG
;
Ki Tak JU
;
Soo Mee BANG
;
Yiel Hea SEO
;
Dong Bok SHIN
;
Jae Hoon LEE
Author Information
1. Department of Internal Medicine, Gachon Medical School, Gil Medical Center, Inchon, Korea.
- Publication Type:Original Article
- Keywords:
t (8;
21);
AML1/ETO;
PCR;
Morphology;
Prognosis
- MeSH:
Adult;
Bone Marrow;
Cytarabine;
Disease-Free Survival;
Female;
Humans;
Incidence;
Leukemia, Myeloid, Acute*;
Male;
Pathology, Molecular;
Polymerase Chain Reaction;
Prognosis;
RNA;
RNA-Directed DNA Polymerase
- From:Korean Journal of Medicine
2001;61(6):650-659
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The t (8;21) (q22;q22), which produces the fusion gene AML1/ETO, is associated with relatively good prognosis and, in particular, with a good response to cytosine arabinoside. Analysis of t (8;21) positive leukemic blasts has shown characteristic morphological and immunological features. We performed this study to investigate the incidence of AML1/ETO rearrangement in adult AML, especially in M2 subtype, to make a comparison of morphologic, immunophenotypic and clinical characteristics between AML1/ETO rearrangement positive and negative group in patient with AML and to analyze the correlation with other biological parameters. METHODS: From May 1995 to Sep. 2000, fifty-nine patients with AML including twenty-nine AML-M2 were studied. RNAs were extracted from leukemic cells and reverse transcriptase mediated polymerase chain reaction (RT-PCR) for AML1/ETO fusion transcript was done. Chromosome study, immunophenotypic, and clinical characteristics were analysed and statistical analysis was done. RESULTS: The male to female ratio was 32:27 in AML and 17:12 in AML-M2. The median age was 43 years (range 14-86) in AML and 43 years (range 14-77) in AML-M2. The incidence of AML1/ETO fusion transcripts was 22.0% in AML and 44.8% in AML-M2. The morphologic finding of bone marrow in AML-M2 showed higher incidence of Auer rods, large blast with prominent golgi and abnormal granules in AML1/ETO positive patients. There was no significant difference of immunophenotype. AML patients with AML1/ETO rearrangement had a tendency of higher complete remission rate (81.8% vs 56.6%, p=0.13). The overall survival (median 82.2 weeks vs 34.4 weeks, p=0.02) and progression free survival (median 50.9 weeks vs 20.4 weeks, p=0.02) of AML1/ETO positive group were longer than those of negative group in AML. AML-M2 patients with AML1/ETO rearrangement had also a tendency of longer overall survival and progression free survival, although there was no significant difference between both group (median OS 82.4 weeks vs 15.6 weeks, p=0.07, median PFS 50.9 weeks vs 16.0 weeks, p=0.09). CONCLUSION: Our data suggest that AML1/ETO rearrangement is detected frequently in AML, especially M2, and is a favorable prognostic factor. Thus, molecular diagnostic approaches should be used routinely to identify patients with this genetic subtype of AML.
