Value of Measurable Residual Disease Monitoring in Patients With Acute Promyelocytic Leukemia in the Era of Frontline ‘Chemotherapy-Free’ Therapy

Authors

Jorge M Ramos Perez
Keyur P Patel
Sanam Loghavi
Guillermo Garcia-Manero
Gautam Borthakur
Elias Jabbour
William Wierda
Sherry Pierce
Mark Brandt
Steven Kornblau
Tapan Kadia
Naval Daver
Courtney D DiNardo
Nitin Jain
Musa Yilmaz
Nicholas Short
Srdan Verstovsek
Alessandra Ferrajoli
Michael Andreeff
Marina Konopleva
Daniel Rivera
David McCue
Hagop M Kantarjian
Farhad Ravandi

Publication Date

3-1-2022

Journal

Leukemia & Lymphoma

Abstract

Acute promyelocytic leukemia (APL) is characterized by the chromosomal translocation t(15;17) and the resulting gene PML-RARA, used for measurable residual disease (MRD) monitoring. Despite highly effective therapy for APL, MRD monitoring practices are not fully established. We aimed to assess the value of MRD monitoring by RT-qPCR in patients with APL treated with ATRA and arsenic trioxide +/- GO. We reviewed 223 patients with APL treated with this regimen. RT-qPCR for PML-RARA was measured every 3 months, and at 12, 18, and 24 months after therapy. Seven patients relapsed. Time to relapse was 7.9-12.4 months in 6 patients, and one patient relapsed after 79.5 months. These data show that MRD monitoring may be important for the detection of relapse in patients treated with this regimen within one year after completing therapy, however, since late molecular relapse is rare, our data suggest a low value of MRD monitoring beyond that first year.

Keywords

Arsenic Trioxide, Arsenicals, Humans, Leukemia, Promyelocytic, Acute, Neoplasm, Residual, Oxides, Recurrence, Translocation, Genetic, Tretinoin, APL, ATRA plus ATO, MRD monitoring

DOI

10.1080/10428194.2021.1992757

PMID

34668451

PMCID

PMC11749422

PubMedCentral® Posted Date

1-21-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes