IDH1/2 but not DNMT3A mutations are suitable targets for minimal residual disease monitoring in acute myeloid leukemia patients: a study by the Acute Leukemia French Association - PubMed (original) (raw)

. 2015 Dec 8;6(39):42345-53.

doi: 10.18632/oncotarget.5645.

Delphine Lebon 3, Christophe Roumier 2 4, Meyling Cheok 4 5, Alice Marceau-Renaut 2 4, Olivier Nibourel 2 4, Sandrine Geffroy 2 4, Nathalie Helevaut 2, Philippe Rousselot 6, Bérengère Gruson 3, Claude Gardin 7, Marie-Lorraine Chretien 8, Shéhérazade Sebda 5, Martin Figeac 5, Céline Berthon 1 4, Bruno Quesnel 1 4, Nicolas Boissel 9, Sylvie Castaigne 6, Hervé Dombret 9, Aline Renneville 2 4, Claude Preudhomme 2 4

Affiliations

IDH1/2 but not DNMT3A mutations are suitable targets for minimal residual disease monitoring in acute myeloid leukemia patients: a study by the Acute Leukemia French Association

Houria Debarri et al. Oncotarget. 2015.

Abstract

Acute myeloid leukemia (AML) is a heterogeneous disease. Even within the same NPM1-mutated genetic subgroup, some patients harbor additional mutations in FLT3, IDH1/2, DNMT3A or TET2. Recent studies have shown the prognostic significance of minimal residual disease (MRD) in AML but it remains to be determined which molecular markers are the most suitable for MRD monitoring. Recent advances in next-generation sequencing (NGS) have provided the opportunity to use multiple molecular markers. In this study, we used NGS technology to assess MRD in 31 AML patients enrolled in the ALFA-0701 trial and harboring NPM1 mutations associated to IDH1/2 or DNMT3A mutations. NPM1 mutation-based MRD monitoring was performed by RTqPCR. IDH1/2 and DNMT3A mutations were quantified by NGS using an Ion Torrent Proton instrument with high coverage (2 million reads per sample). The monitoringof IDH1/2 mutations showed that these mutations were reliable MRD markers that allowed the prediction of relapse in the majority of patients. Moreover, IDH1/2 mutation status predicted relapse or disease evolution in 100% of cases if we included the patient who developed myelodysplastic syndrome. In contrast, DNMT3A mutations were not correlated to the disease status, as we found that a preleukemic clone with DNMT3A mutation persisted in 40% of the patients who were in complete remission, reflecting the persistence of clonal hematopoiesis.

Keywords: acute myeloid leukemia; minimal residual disease; next-generation sequencing.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

Figures

Figure 1

Figure 1. MRD monitoring in AML patients using NGS to analyze IDH1 mutations and using RTqPCR to analyze NPM1 mutations

A. Discrepancy between IDH1 and NPM1 mutations according to the MRD stages in patient 5. B. Correlation between IDH1 and NPM1 mutations according to the MRD stages in patient 2.

Figure 2

Figure 2. MRD monitoring in AML patients with DNMT3A mutations using NGS and NPM1 mutations using quantitative RTqPCR

A. Discrepancy between DNMT3A and NPM1 mutation rates according to MRD stages in patient 31. B. Correlation between DNMT3A and NPM1 mutations rates according to MRD stages in patient 28.

Figure 3

Figure 3. Sequencing results for the different blood fractions showing DNMT3A mutations in all fractions except in the CD3+ T lymphocyte fraction

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