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Type: Journal article
Title: BCR-ABL1 expression, RT-qPCR and treatment decisions in chronic myeloid leukaemia
Author: Latham, S.
Bartley, P.
Budgen, B.
Ross, D.
Hughes, E.
Branford, S.
White, D.
Hughes, T.
Morley, A.
Citation: Journal of Clinical Pathology, 2016; 69(9):817-821
Publisher: BMJ Publishing Group
Issue Date: 2016
ISSN: 0021-9746
Statement of
Susan Latham, Paul A Bartley, Bradley Budgen, David M Ross, Elizabeth Hughes, Susan Branford, Deborah White, Timothy P Hughes, Alexander A Morley
Abstract: RT-qPCR is used to quantify minimal residual disease (MRD) in chronic myeloid leukaemia (CML) in order to make decisions on treatment, but its results depend on the level of BCR-ABL1 expression as well as leukaemic cell number. The aims of the study were to quantify inter-individual differences in expression level, to determine the relationship between expression level and response to treatment, and to investigate the effect of expression level on interpretation of the RT-qPCR result.BCR-ABL1 expression was studied in 248 samples from 65 patients with CML by determining the difference between MRD quantified by RT-qPCR and DNA-qPCR. The results were analysed statistically and by simple indicative modelling.Inter-individual levels of expression approximated a normal distribution with an SD of 0.36 log. Expression at diagnosis correlated with expression during treatment. Response to treatment, as measured by the number of leukaemic cells after 3, 6 or 12 months of treatment, was not related to the level of expression. Indicative modelling suggested that interpretation of RT-qPCR results in relation to treatment guidelines could be affected by variation in expression when MRD was around 10% at 3 months and by both expression variation and Poisson variation when MRD was around or below the limit of detection of RT-qPCR.Variation between individuals in expression of BCR-ABL1 can materially affect interpretation of the RT-qPCR when this test is used to make decisions on treatment.
Keywords: Neoplasm, Residual
Rights: © 2016, BMJ Publishing Group Ltd and the Association of Clinical Pathologists
DOI: 10.1136/jclinpath-2015-203538
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