Minimal residual disease level predicts outcomes in the non-favorable risk patients with acute myeloid leukemia
10.3760/cma.j.issn.0253-2727.2017.07.005
- VernacularTitle: 微小残留病在成人急性髓系白血病非预后良好型患者中的预后价值
- Author:
Xin REN
1
;
Ting ZHAO
;
Jing WANG
;
Honghu ZHU
;
Hao JIANG
;
Jinsong JIA
;
Shenmiao YANG
;
Bin JIANG
;
Debing WANG
;
Xiaojun HUANG
;
Qian JIANG
Author Information
1. Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China
- Publication Type:Journal Article
- Keywords:
Leukemia, myeloid, acute;
Minimal residual disease;
Prognosis
- From:
Chinese Journal of Hematology
2017;38(7):578-585
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore impact of minimal residual leukemia (MRD) on outcomes in the non-favorable risk adults with de novo acute myeloid leukemia (AML) .
Methods:From January 2008 to February 2016, data of consecutive newly-diagnosed non-favorable risk adults with AML (non-APL) according to SWOG criteria who achieved morphologic leukemia-free state (MLFS) and received continuous chemotherapy were assessed retrospectively.
Results:292 AML patients were enrolled, 150 (51.4%) were male. Median age was 46 years (range, 18-65 years) . Using the SWOG cytogenetic classification, 186 (63.7%) , 49 (16.8%) and 57 (19.5%) patients belonged to intermediate, unfavorable and unknown categories, respectively. With a median follow-up period of 15 months (range, 1 to 94 months) in survivors, the probabilities of cumulative rates of relapse (CIR) , disease free survival (DFS) and overall survival (OS) at 2-years were 51.6%, 42.6% and 60.0%, respectively. Multivariate analyses showed that MRD positive (defined as Q-PCR WT1 mRNA ≥0.6% or any level of abnormal blast population detected by flow cytometry) after achieving MLFS and PLT<100×109/L were common adverse factors affecting CIR and DFS. In addition, positive FLT3-ITD mutation and CRp/CRi had negatively impact on CIR, DFS and OS. Monosomal karyotype was adverse factors affecting CIR and OS. Age ≥44 years and unfavorable-risk of SWOG criteria were associated with shorter DFS.
Conclusions:MRD level after achieving MLFS had prognostic significance on outcomes in non-favorable adults with AML who received continuous chemotherapy after achieving MLFS.
