Real-Time Quantitative RT-PCR to Detect Fusion Gene Transcripts Associated With AML

Relapse remains a major cause of treatment failure in acute myeloid leukemia (AML); however, patients destined to relapse cannot be reliably distinguished on the basis of pretreatment characteristics. Hence, there has been considerable interest in strategies for detection of minimal residual disease (MRD) as a means of identifying patients at high risk from relapse who could benefit from additional therapy. Moreover, MRD monitoring also affords the opportunity to reveal subsets of patients at low risk of relapse who could be spared excessive therapy, thereby reducing the risk of treatment related mortality and morbidity. Previous studies have confirmed that MRD monitoring using PCR- or flow cytometric-based approaches provides key independent prognostic information in a number of subtypes of leukemia and is increasingly being used for risk stratification as a means of directing treatment approach (see refs. 1 ,2 for recent reviews).