Format

Send to

Choose Destination
Leuk Res. 2016 Jan;40:1-9. doi: 10.1016/j.leukres.2015.10.002. Epub 2015 Oct 22.

Minimal residual disease evaluation by flow cytometry is a complementary tool to cytogenetics for treatment decisions in acute myeloid leukaemia.

Author information

1
Department of Hematology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Spain; Instituto de Biología Molecular y Celular del Cáncer (CIC-CSIC), Salamanca, Spain.
2
Department of Hematology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Spain. Electronic address: estefipe83@hotmail.com.
3
Department of Hematology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Spain.
4
Department of Hematology, Hospital Universitario de San Carlos, Madrid, Spain.
5
Department of Hematology, Hospital Central de Asturias, Oviedo, Spain.
6
Department of Hematology, Complejo Hospitalario de León, León, Spain.
7
Department of Hematology, Hospital Universitario Alicante, Alicante, Spain.
8
Department of Hematology, Complejo Asistencial de Ávila, Ávila, Spain.
9
Department of Hematology, Hospital Clínico Universitario, Valladolid, Spain.
10
Department of Hematology, Hospital Río Carrión, Palencia, Spain.
11
Department of Hematology, Complejo Asistencial, Segovia, Spain.
12
Department of Hematology, Hospital Universitario La Fe, Valencia, Spain.
13
Department of Hematology, Hospital Materno Insular, Las Palmas de Gran Canaria, Spain.
14
Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
15
Department of Hematology, Hospital Virgen de la Concha, Zamora, Spain.
16
Department of Hematology, Hospital Universitario Dr. Peset, Valencia, Spain.
17
Instituto de Biología Molecular y Celular del Cáncer (CIC-CSIC), Salamanca, Spain; Department of Cytometry, Universidad de Salamanca, Spain.

Abstract

The clinical utility of minimal residual disease (MRD) analysis in acute myeloid leukaemia (AML) is not yet defined. We analysed the prognostic impact of MRD level at complete remision after induction therapy using multiparameter flow cytometry in 306 non-APL AML patients. First, we validated the prognostic value of MRD-thresholds we have previously proposed (≥ 0.1%; ≥ 0.01-0.1%; and <0.01), with a 5-year RFS of 38%, 50% and 71%, respectively (p=0.002). Cytogenetics is the most relevant prognosis factor in AML, however intermediate risk cytogenetics represent a grey zone that require other biomarkers for risk stratification, and we show that MRD evaluation discriminate three prognostic subgroups (p=0.03). Also, MRD assessments yielded relevant information on favourable and adverse cytogenetics, since patients with favourable cytogenetics and high MRD levels have poor prognosis and patients with adverse cytogenetics but undetectable MRD overcomes the adverse prognosis. Interestingly, in patients with intermediate or high MRD levels, intensification with transplant improved the outcome as compared with chemotherapy, while the type of intensification therapy did not influenced the outcome of patients with low MRD levels. Multivariate analysis revealed age, MRD and cytogenetics as independent variables. Moreover, a scoring system, easy in clinical practice, was generated based on MRD level and cytogenetics.

KEYWORDS:

Acute myeloid leukaemia; Flow cytometry; Minimal residual disease; Prognosis

PMID:
26598032
DOI:
10.1016/j.leukres.2015.10.002
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center