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Early assessment of minimal residual disease in AML by flow cytometry during aplasia identifies patients at increased risk of relapse.

Abstract：

:In acute myeloid leukemia (AML), assessment of minimal residual disease (MRD) by flow cytometry (flow MRD) after induction and consolidation therapy has been shown to provide independent prognostic information. However, data on the value of earlier flow MRD assessment are lacking. Therefore, the value of flow MRD detection was determined during aplasia in 178 patients achieving complete remission after treatment according to AMLCG (AML Cooperative Group) induction protocols. Flow MRD positivity during aplasia predicted poor outcome (5-year relapse-free survival (RFS) 16% vs 43%, P<0.001) independently from age and cytogenetic risk group (hazard ratio for MRD positivity 1.71; P=0.009). Importantly, the prognosis of patients without detectable MRD was neither impacted by morphological blast count during aplasia nor by MRD status postinduction. Early flow MRD was also evaluated in the context of existing risk factors. Flow MRD was prognostic within the intermediate cytogenetic risk group (5-year RFS 15% vs 37%, P=0.016) as well as for patients with normal karyotype and NPM1 mutations (5-year RFS 13% vs 49%, P=0.02) or FLT3-ITD (3-year RFS rates 9% vs 44%, P=0.016). Early flow MRD assessment can improve current risk stratification approaches by prediction of RFS in AML and might facilitate adaptation of postremission therapy for patients at high risk of relapse.

journal_name

Leukemia

journal_title

Leukemia

authors

Köhnke T,Sauter D,Ringel K,Hoster E,Laubender RP,Hubmann M,Bohlander SK,Kakadia PM,Schneider S,Dufour A,Sauerland MC,Berdel WE,Büchner T,Wörmann B,Braess J,Hiddemann W,Spiekermann K,Subklewe M

doi

10.1038/leu.2014.186

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

377-86

issue

2

eissn

0887-6924

issn

1476-5551

pii

leu2014186

journal_volume

29

pub_type

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