Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Reply to Martinelli et al

Leukemia volume 17, pages 651–652 (2003)Cite this article

The interesting data reported by Martinelli et al in Leukemia,1 recalcutated from the article recently published in Blood,2 are entirely consistent with ours3 and with the previous ones published in Leukemia by Marcucci et al.4 In all the above papers, authors concluded that a threshold level of CBFbeta/MYH11 transcript copy number able to distinguish patients in clinical remission (CR) with high and low risk of relapse could be defined. However, two crucial issues remain unsettled so far: (1) the absolute copy number of the threshold level that varied slightly but significantly among the above labs; and (2) the timing of bone marrow sampling during CR most useful in predicting patient clinical outcome. With regard to the first issue, many variables of CBFbeta/MYH11 real-time PCR procedure need to be standardized: the European Sanco Concerted Action has devoted many efforts to this task in order to reduce interlabs variability and to implement highly reproducible assays. Moreover, we agree with Martinelli et al1 that the level of minimal residual disease (MRD) observed during CR is critically determined by the timing of bone marrow sampling as well as by the chemotherapy protocol adopted (ie standard vs high doses of ARAC). In this connection, we have recently updated our preliminary results3 of quantitative MRD after induction and consolidation in patients treated with standard doses of ARAC: after induction, 6/7 patients with >100 copies of leukemic transcript relapsed compared to 2/12 with <100 copies (P=0.003): moreover, after consolidation, 8/11 patients with >10 copies vs 2/12 with <10 copies (P=0.006) relapsed. It could be interesting to ascertain if similar results were found in patients treated with high-dose ARAC regimens as in the protocol employed by Martinelli et al;1 nevertheless, our results suggest that early monitoring of MRD after induction or consolidation therapy is predictive of relapse, thus allowing timely treatment changes to overcome resistant disease. In conclusion, we believe that available data of real-time PCR of inv(16) leukemia are by now relevant to the patients outcome and treatment, aiding clinicians to implement more tailored therapeutic approaches.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Martinelli G, Buonamici S, Visani G, Malagola M, Piccaluga P, Isidori A et al. Molecular monitoring of acute myeloid leukemia associated with inv(16): threshold of CBFβ/MYH11 transcript copy number above which relapse occurs and below which continuous CR is likely. Leukemia 2003; 17: 650–651.

    Article  CAS  Google Scholar 

  2. Buonamici S, Ottaviani E, Testoni N, Montefusco V, Visani G, Bonifazi F et al. Real-time quantitation of minimal residual disease in inv(16)-positive acute myeloid leukemia may indicate risk for clinical relapse and may identify patients in a curable state. Blood 2002; 99: 443–449.

    Article  CAS  Google Scholar 

  3. Guerrasio A, Pilatrino C, De Micheli D, Cilloni D, Serra A, Gottardi E et al. Assessment of minimal residual disease (MRD) in CBFbeta/MYH11-positive acute myeloid leukemias by qualitative and quantitative RT-PCR amplification of fusion transcripts. Leukemia 2002; 16: 1176–1181.

    Article  CAS  Google Scholar 

  4. Marcucci G, Caligiuri MA, Dohner H, Archer KJ, Schlenk RF, Dohner K et al. Quantification of CBFbeta/MYH11 fusion transcript by real time RT-PCR in patients with INV(16) acute myeloid leukemia. Leukemia 2001; 15: 1072–1080.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Orbassano, Torino, Italy

    A Guerrasio, C Pilatrino, D Cilloni, E Gottardi & G Saglio

Authors
  1. A Guerrasio
    View author publications

    Search author on:PubMed Google Scholar

  2. C Pilatrino
    View author publications

    Search author on:PubMed Google Scholar

  3. D Cilloni
    View author publications

    Search author on:PubMed Google Scholar

  4. E Gottardi
    View author publications

    Search author on:PubMed Google Scholar

  5. G Saglio
    View author publications

    Search author on:PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guerrasio, A., Pilatrino, C., Cilloni, D. et al. Reply to Martinelli et al. Leukemia 17, 651–652 (2003). https://doi.org/10.1038/sj.leu.2402823

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/sj.leu.2402823

Search

Advanced search

Quick links