Detection of Minimal Residual Disease on Bone Marrow Smears by Reverse Transcriptase Polymerase Chain Reaction
The polymerase chain reaction (PCR) is now often used for the identification of the three most common chromosomal aberrations, t(8; 21), t(15; 17) and inv(16), in adult AML, which account for 30%-40% of chromosomal aberrations in de novo AML. In addition, the high sensitivity of this technique has provided a way to detect residual leukaemia at previously unobtainable levels. For primary diagnosis one bone marrow aspirate smear is sufficient for the reverse transcriptase (RT) PCR assay. This source has the advantage that no special handling and transport of the specimen is necessary. The aim of the present study was to detect minimal residual disease on bone marrow smears and to compare the results with the detection of the fusion transcript in bone marrow aspirates. In 21 patients with AML or ALL in complete clinical and haematological remission (7 Patients with t(15; 17), 4 Patients with t(8; 21), 7 Patients with inv(16) and 3 Patients with t(9; 22)) bone marrow smears as well as 3 ml bone marrow aspirate were investigated. The normal gene could be detected from the glass slide smear and the bone marrow aspirate in every case. The specific translocation as a marker for minimal residual disease was observed in 10 of the 21 cases from the bone marrow smear. In the control with the bone marrow aspirate the specific translocation was detectable in only 7 of these 10 cases. These results demonstrate that bone marrow smears are a suitable source for RT-PCR-based detection of minimal residual disease. Further studies should evaluate this possibility.
KeywordsAcute Myeloid Leukemia Minimal Residual Disease Bone Marrow Aspirate Fusion Transcript Bone Marrow Smear
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