The comparison of predicting clinical outcomes between immunolophenotype and hematological complete remission before human leukocyte antigen-matched sibling donor transplantation in acute myeloid leukemia
10.3760/cma.j.issn.0253-2727.2018.08.001
- VernacularTitle: 移植前免疫表型缓解与血液形态学缓解对急性髓系白血病患者同胞HLA相合造血干细胞移植疗效预测价值的比较
- Author:
Jing LIU
1
;
Yanrong LIU
;
Yazhe WANG
;
Wei HAN
;
Huan CHEN
;
Yao CHEN
;
Jingzhi WANG
;
Xiaodong MO
;
Yuanyuan ZHANG
;
Chenhua YAN
;
Yuqian SUN
;
Yuhong CHEN
;
Yu WANG
;
Lanping XU
;
Xiaohui ZHANG
;
Kaiyan LIU
;
Xiaojun HUANG
;
Yingjun CHANG
Author Information
1. Institute of Hematology, Peoples’ Hospital, Peking University, Beijing 100044, China
- Publication Type:Journal Article
- Keywords:
Leukemia, myeloid, acute;
Hematopoietic stem cell transplantation;
Hematological complete remission;
Immunophenotype complete remission
- From:
Chinese Journal of Hematology
2018;39(8):617-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the prognostic significance of immunophenotype complete remission (ICR) and hematological complete remission (HCR) before human-leukocyte antigen (HLA)-matched sibling donor transplantation (MSDT) in acute myeloid leukemia (AML) patients.
Methods:A cohort of 182 AML (non-APL) patients undergoing MSDT in HCR was retrospectively studied [including complete remission with ANC and PLT recovery (CR), CR with incomplete PLT recovery (CRp), CR with inconplete ANC and PLT recovery (CRi)]; ICR was determined as undetective minimal resudial disease (MRD) by multi-parameter flow cytometer.
Results:①Of the 182 patients, 97 were male, 85 female, and the median age was 41(4-62) years. ②The CR and CRi+CRp rates were 80.8% (147/182) and 19.2%(35/182), respectively; The 4-year cumulative incidence of relapse[CIR, (11.0±4.3)% vs (16.0±7.1)%, χ2=0.274, P=0.600], non-relapse mortality[NRM, (14.0±4.3)% vs (9.0±6.3)%, χ2=0.913, P=0.339], leukemia-free survival[LFS, (75.0±5.1)% vs (75.0±8.3)%, χ2=0.256, P=0.613], and overall survial [OS, (77.0±5.2)% vs (80.0±8.1)%, χ2=0.140, P=0.708] were comparable between the CRp+CRi and CR groups. ③Compared with the non-ICR group (n=35), the ICR group (n=147) showed lower 4-year CIR [(11.3±3.4) % vs (55.2±8.8) %, χ2=32.687, P<0.001], better 4-year LFS [(76.2±4.7)% vs (32.8±8.7)%, χ2=26.234, P<0.001] and OS[(79.0±4.7)% vs (39.0±9.1)%, χ2=25.253, P<0.001], and comparable NRM[(12.5±4.1)% vs (12.0±7.1)%, χ2=1.002, P=0.656]. ④Mulitvariate analysis confirmed the independent prognostic value of ICR in lower CIR [HR=11.026(95%CI 4.685-25.949), P<0.001], higher LFS [HR=5.785 (95% CI 2.974-11.254), P<0.001] and OS[HR=5.578 (95% CI 2.575-27.565), P<0.001].
Conclusion:The results indicated that ICR instead of HCR pre-transplantation had a significant prognostic value in AML patients undergoing MSDT.
