High resolution banding technique in detection of minimal residual disease in acute myeloid leukemia

ABSTRACT

A significant proportion of patients with acute myeloid leukemia who achieve remission subsequently experience frank relapse of their disease, and their ultimate prognosis is typically poor. Investigation of minimal residual disease has proven to be a valuable tool for predicting impending relapse before clinical and hematologic manifestations. The aim of this study was the detection of minimal residual disease in AML patients fallowing complete remission [CR] using high resolution chromosome banding technique of bone marrow specimens and their implication on clinical course of the disease. The present study included 27 patients with de novo AML as initial series. Their diagnosis was based on morphological and immunophenotypical criteria. Among these, 15 patients [55.5%] achieved morphologic complete remission, whom the present study was done on that cases for one year of follow up for detection of relapse; 3 patients were M1, 5 were M2, 2 were M3, 2 were M4 and 3 were M5. High resolution banding technique of bone marrow cells revealed that seven patients [7/15; 47%] had cytogenetic abnormalities; 3 had chromosomal translocations [t[6;9], t[15;17], t[l;8]], one with chromosome 5 monosomy, one deletion [del [7q]], one chromosome duplication [dup [13q]] and one with trisomy 8. During the follow up period, 71% [5/7] of cases with cytogenetic abnormalities relapsed, while 37.5% [3/8] of cases with normal cytogenetics relapsed. There was a significant difference between those who relapsed and had cytogenetic abnormalities and those who relapsed and had normal cytogenetics in their response to treatment. In conclusion, high resolution chromosome banding technique of bone marrow cells is valuable in the detection of minimal residual disease in AML and therefore patients at high risk of relapse could be identified for better management