Impact of measurable residual disease by decentralized flow cytometry: a PETHEMA real-world study in 1076 patients with acute myeloid leukemia
Por:
Paiva B, Vidriales MB, Sempere A, Tarín F, Colado E, Benavente C, Cedena MT, Sánchez J, Caballero-Velazquez T, Cordón L, Garces JJ, Simoes C, Martínez-Cuadrón D, Bernal T, Botella C, Grille S, Serrano J, Rodríguez-Medina C, Algarra L, Alonso-Domínguez JM, Amigo ML, Barrios M, García-Boyero R, Colorado M, Pérez-Oteyza J, Pérez-Encinas M, Costilla-Barriga L, Sayas MJ, Pérez O, González-Díaz M, Pérez-Simón JA, Martínez-López J, Sossa C, Orfao A, San Miguel JF, Sanz MÁ, Montesinos P and PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) coo
Publicada:
1 ago 2021
Ahead of Print:
1 feb 2021
Resumen:
The role of decentralized assessment of measurable residual disease (MRD) for risk stratification in acute myeloid leukemia (AML) remains largely unknown, and so it does which methodological aspects are critical to empower the evaluation of MRD with prognostic significance, particularly if using multiparameter flow cytometry (MFC). We analyzed 1076 AML patients in first remission after induction chemotherapy, in whom MRD was evaluated by MFC in local laboratories of 60 Hospitals participating in the PETHEMA registry. We also conducted a survey on technical aspects of MRD testing to determine the impact of methodological heterogeneity in the prognostic value of MFC. Our results confirmed the recommended cutoff of 0.1% to discriminate patients with significantly different cumulative-incidence of relapse (-CIR- HR:0.71, P < 0.001) and overall survival (HR: 0.73, P = 0.001), but uncovered the limited prognostic value of MFC based MRD in multivariate and recursive partitioning models including other clinical, genetic and treatment related factors. Virtually all aspects related with methodological, interpretation, and reporting of MFC based MRD testing impacted in its ability to discriminate patients with different CIR. Thus, this study demonstrated that "real-world" assessment of MRD using MFC is prognostic in patients at first remission, and urges greater standardization for improved risk-stratification toward clinical decisions in AML.
Filiaciones:
Paiva B:
Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), IDISNA, CIBER-ONC number CB16/12/00369, Pamplona, Spain
Vidriales MB:
Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC (CB16/12/002333) and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
Sempere A:
Hospital Universitario y Politécnico La Fe, CIBER-ONC number CB16/12/00284, Valencia, Spain
Tarín F:
Hospital General Universitario de Alicante, Alicante, Spain
Colado E:
Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria y Universitario Oncológico del Principado de Asturias (ISPA / IUOPA), Oviedo, Spain
Benavente C:
Hospital Clínico San Carlos, Madrid, Spain
Cedena MT:
Hospital Universitario 12 de Octubre, Madrid, Spain
Sánchez J:
Hospital Reina Sofía, Córdoba, Spain
Caballero-Velazquez T:
Hopsital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS / CSIC / CIBERONC), Universidad de Sevilla, Sevilla, Spain
Cordón L:
Hospital Universitario y Politécnico La Fe, CIBER-ONC number CB16/12/00284, Valencia, Spain
Garces JJ:
Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), IDISNA, CIBER-ONC number CB16/12/00369, Pamplona, Spain
Simoes C:
Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), IDISNA, CIBER-ONC number CB16/12/00369, Pamplona, Spain
Martínez-Cuadrón D:
Hospital Universitario y Politécnico La Fe, CIBER-ONC number CB16/12/00284, Valencia, Spain
Bernal T:
Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria y Universitario Oncológico del Principado de Asturias (ISPA / IUOPA), Oviedo, Spain
Botella C:
Hospital General Universitario de Alicante, Alicante, Spain
Grille S:
Hospital de Clinicas. Montevideo, Uruguay, Spain
Serrano J:
Hospital Reina Sofía, Córdoba, Spain
Rodríguez-Medina C:
Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Spain
Algarra L:
Hospital General de Albacete, Albacete, Spain
Alonso-Domínguez JM:
Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
Amigo ML:
Hospital Morales Messeguer, Murcia, Spain
Barrios M:
Hospital Regional Universitario de Málaga, Malaga, Spain
:
Hospital General Universitario de Castellón, Castellón de la Plana, Spain
Colorado M:
Hospital Universitario Marqués de Valdecilla, Santander, Spain
Pérez-Oteyza J:
Hospital HM Madrid, Madrid, Spain
Pérez-Encinas M:
Hospital Clinico de Santiago de Compostela, Santiago de Compostela, Spain
Costilla-Barriga L:
Hospital Miguel Servet, Zaragoza, Spain
:
Hospital Universitario Dr. Peset, Valencia, Spain
Pérez O:
Hospital Universitario Virgen Macarena, Sevilla, Spain
González-Díaz M:
Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC (CB16/12/002333) and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
Pérez-Simón JA:
Hopsital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS / CSIC / CIBERONC), Universidad de Sevilla, Sevilla, Spain
Martínez-López J:
Hospital Universitario 12 de Octubre, Madrid, Spain
Sossa C:
Clinica FOSCAL, Santander, Colombia
Orfao A:
Cancer Research Center (IBMCC-CSIC/USAL-IBSAL)
Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain
(USAL) Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Salamanca, Spain
CIBER-ONC number CB16/12/00400, Salamanca, Spain
San Miguel JF:
Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), IDISNA, CIBER-ONC number CB16/12/00369, Pamplona, Spain
Sanz MÁ:
Hospital Universitario y Politécnico La Fe, CIBER-ONC number CB16/12/00284, Valencia, Spain
Montesinos P:
Hospital Universitario y Politécnico La Fe, CIBER-ONC number CB16/12/00284, Valencia, Spain.
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