Scientists have now developed a DNA-based test that can determine the risk of relapse of leukemia patients. Specifically, patients with acute myeloid leukemia (AML) – the most common form of acute leukemia in adults – will re-enter chemotherapy and bone marrow transplantation. This prognosis may help physicians adjust the treatment early before the cancer returns completely. This is reported by the online science forum Medicalexpress. For the study, researchers examined 529 bone marrow samples from 104 AML patients undergoing chemotherapy and bone marrow transplantation. The samples were taken at different times: at the time of diagnosis, during chemotherapy, and three weeks after bone marrow transplantation. The result: The researchers identified DNA mutations that were present at the time of diagnosis and searched for the same mutations in all other samples. They found that during chemotherapy and bone marrow transplantation, most leukemia cells were eliminated, which reduced the mutations. However, some initial mutations could still be detected three weeks after transplantation, indicating the presence of treatment-resistant cancer cells. As these mutations accumulate in a relapse, the data suggest that the same cancer cells that have triggered the leukemia are also responsible for the return of the disease.
Using next generation sequencing (NGS) DNA sequencing technology, the team was able to identify treatment-resistant leukemia cells or clones, even if they accounted for a tiny fraction of all bone marrow cells. The nature of the mutations also shows further indications of how best to treat the disease with drugs. What is the significance of the DNA test? "Next Generation Sequencing is a well-known procedure and is also used, for example, in AML diagnosis. However, the statutory health insurance companies do not yet cover the costs. The study now published is a further development of this technology, "explains Prof. Ahmet Elmaagacli, Medical Director of Hemato / Oncology and Stem Cell Transplantation, Asklepios St. Georg Clinic. Characteristically for AML is a sudden onset, the disease is progressing rapidly and must be promptly treated become.
Part of the treatment is chemotherapy, followed by a bone marrow transplant, as long as the age and severity of the disease allow it. About one third of the patients relapse three to six months later.
"The majority of AML disorders in patients of a transplantable age – usually up to 70-75 years and depending on the remaining health status – are transplanted allogeneic (recipients and donors are different individuals). In the case of AML, gene mutations are predominantly detectable. Relapses of AML often occur during transplantation. However, it is already sought therapy standard with various methods for molecular markers that detect residues of AML after transplantation. This allows patients with a high risk of relapse to be identified. "By identifying patients at risk, the scientists involved in the study hope to be able to intervene therapeutically in the long term to improve the chances of recovery. The results of Canadian and Korean scientists and physicians have now been published in the journal "Blood". ,