MRD parameters using immunophenotypic detection methods are highly reliable in predicting survival in acute myeloid leukaemia

被引:144
作者
Feller, N [1 ]
van der Pol, MA [1 ]
van Stijn, A [1 ]
Weijers, GWD [1 ]
Westra, AH [1 ]
Evertse, BW [1 ]
Ossenkoppele, GJ [1 ]
Schuurhuis, GJ [1 ]
机构
[1] Vrije Univ Amsterdam, Med Ctr, Dept Hematol, NL-1081 HV Amsterdam, Netherlands
关键词
AML; minimal residual disease; PBSC products; immunophenotype;
D O I
10.1038/sj.leu.2403405
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Outgrowth of minimal residual disease (MRD) in acute myeloid leukaemia (AML) is responsible for the occurrence of relapses. MRD can be quantified by immunophenotyping on a flow cytometer using the expression of leukaemia-associated phenotypes. MRD was monitored in follow-up samples taken from bone marrow (BM) of 72 patients after three different cycles of chemotherapy and from autologous peripheral blood stem cell (PBSC) products. The MRD% in BM after the first cycle (n = 51), second cycle (n = 52) and third cycle (n = 30), as well as in PBSC products (n = 39) strongly correlated with relapse-free survival. At a cutoff level of 1% after the first cycle and median cutoff levels of 0.14% after the second, 0.11% after the third cycle and 0.13% for PBSC products, the relative risk of relapse was a factor 6.1, 3.4, 7.2 and 5.7, respectively, higher for patients in the high MRD group. Also, absolute MRD cell number/ml was highly predictive of the clinical outcome. After the treatment has ended, an increase of MRD% predicted forthcoming relapses, with MRD assessment intervals of less than or equal to3 months. In conclusion, MRD parameter assessment at different stages of disease is highly reliable in predicting survival and forthcoming relapses in AML.
引用
收藏
页码:1380 / 1390
页数:11
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