Minimal residual disease evaluation by flow cytometry is a complementary tool to cytogenetics for treatment decisions in acute myeloid leukaemia
Por:
Vidriales, M, Perez-Lopez, E, Pegenaute, C, Castellanos, M, Perez, J, Chandia, M, Diaz-Mediavilla, J, Rayon, C, de las Heras, N, Fernandez P, Cabezudo, M, Garcia de Coca, A, Ma Alonso, J, Olivier, C, Ma Hernandez-Rivas, J, Montesinos, P, Fernandez, R, Garcia-Suarez, J, Garcia, M, Sayas, M, Paiva, B, Gonzalez, M, Orfao, A, San Miguel, J and PETHEMA Programa Estudio Terapeuti
Publicada:
1 ene 2016
Ahead of Print:
22 oct 2015
Resumen:
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. (C) 2015 Elsevier Ltd. All rights reserved.
Filiaciones:
Vidriales, M:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Inst Biol Mol & Celular Canc CIC CSIC, Salamanca, Spain
Perez-Lopez, E:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Pegenaute, C:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Castellanos, M:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Perez, J:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Chandia, M:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Diaz-Mediavilla, J:
Hosp Univ San Carlos, Dept Hematol, Madrid, Spain
Rayon, C:
Univ Oviedo, Hosp Cent Asturias, Dept Hematol, E-33080 Oviedo, Spain
de las Heras, N:
Complejo Hosp Leon, Dept Hematol, Leon, Spain
Fernandez P:
Hosp Univ Alicante, Dept Hematol, Alicante, Spain
Cabezudo, M:
Complejo Asistencial Avila, Dept Hematol, Avila, Spain
Garcia de Coca, A:
Hosp Clin Univ, Dept Hematol, Valladolid, Spain
Ma Alonso, J:
Hosp Rio Carrion, Dept Hematol, Palencia, Spain
Olivier, C:
Complejo Asistencial, Dept Hematol, Segovia, Spain
Ma Hernandez-Rivas, J:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Inst Biol Mol & Celular Canc CIC CSIC, Salamanca, Spain
Montesinos, P:
Hosp Univ La Fe, Dept Hematol, Valencia, Spain
Fernandez, R:
Hosp Materno Insular, Dept Hematol, Las Palmas Gran Canaria, Spain
Garcia-Suarez, J:
Hosp Univ Principe Asturias, Dept Hematol, Alcala De Henares, Spain
Garcia, M:
Hosp Virgen Concha, Dept Hematol, Zamora, Spain
:
Hosp Univ Dr Peset, Dept Hematol, Valencia, Spain
Paiva, B:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Inst Biol Mol & Celular Canc CIC CSIC, Salamanca, Spain
Gonzalez, M:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Inst Biol Mol & Celular Canc CIC CSIC, Salamanca, Spain
Orfao, A:
Inst Biol Mol & Celular Canc CIC CSIC, Salamanca, Spain
Univ Salamanca, Dept Cytometry, E-37008 Salamanca, Spain
San Miguel, J:
Hosp Univ Salamanca, Dept Hematol, Inst Invest Biomed Salamanca IBSAL, Salamanca 37007, Spain
Inst Biol Mol & Celular Canc CIC CSIC, Salamanca, Spain
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