Abstract

Meningioma 1 (MN1) gene overexpression has been reported in acute myeloid leukaemia (AML) patients and identified as a negative prognostic factor. In order to characterize patients presenting gene overexpression and to verify if MN1 transcript could be a useful marker for minimal residual disease detection, MN1 was quantified in 136 AML patients with different cytogenetic risk and in 50 normal controls. In 20 patients bearing a fusion gene transcript suitable for minimal residual disease quantitative assessment and in 8 patients with NPM1 mutation, we performed a simultaneous analysis of MN1 and the fusion-gene transcript or NPM1 mutation during follow-up. Sequential MN1 and WT1 analysis was also performed in 13 AML patients lacking other molecular markers. The data obtained show that normal cells consistently express low levels of MN1 transcript. In contrast, high levels of MN1 expression are present in 47% of patients with normal karyotype and in all cases with inv(16). MN1 levels during follow-up were found to follow the pattern of other molecular markers (fusion gene transcripts, NPM1 and WT1). Increased MN1 expression in the BM during follow up was always found to be predictive of an impending hematological relapse.

Highlights

  • IntroductionThe detection of minimal residual disease (MRD) by RT-PCR is limited to those patients characterized by genetic markers

  • The assessment of minimal residual disease (MRD) has currently become a necessary strategy to better address treatment intensity in acute leukemias [1]

  • This study suggests that Meningioma 1 (MN1) overexpression is an independent prognostic marker in acute myeloid leukaemia (AML) with normal karyotype and it is associated with shorter relapse free survival (RFS) and shorter overall survival (OS) [14]

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Summary

Introduction

The detection of MRD by RT-PCR is limited to those patients characterized by genetic markers. The latter include fusion genes derived from chromosome translocations, such as PML-RARα AML1 and CBF-MYH112 or mutations, for example nucleophosmin (NPM1), [1, 3] which has been validated as a sensitive marker of MRD detection. Allowed to enlarge the spectrum of genetic abnormalities by discovering new mutations and aberrations [4] Basing on these studies, other genetic markers are under investigation, including IDH1 and IDH2 mutations which occur in less than 10% of the patients[5]. Other genes found overexpressed in AML have been validated for MRD detection in many clinical settings. One of the most exploited is the Wilms tumor gene ( WT1) [6,7,8]

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