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Pre- and post-transplant quantification of measurable ('minimal') residual disease via multiparameter flow cytometry in adult acute myeloid leukemia

Leukemia, 2016-07, Vol.30 (7), p.1456-1464 [Peer Reviewed Journal]

COPYRIGHT 2016 Nature Publishing Group ;COPYRIGHT 2016 Nature Publishing Group ;Copyright Nature Publishing Group Jul 2016 ;Macmillan Publishers Limited 2016. ;ISSN: 0887-6924 ;EISSN: 1476-5551 ;DOI: 10.1038/leu.2016.46 ;PMID: 27012865

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Title:
Pre- and post-transplant quantification of measurable ('minimal') residual disease via multiparameter flow cytometry in adult acute myeloid leukemia
Author: Zhou, Y ; Othus, M ; Araki, D ; Wood, B L ; Radich, J P ; Halpern, A B ; Mielcarek, M ; Estey, E H ; Appelbaum, F R ; Walter, R B
Subjects: Acute myeloid leukemia ; Adolescent ; Adult ; Adults ; Aged ; Bone Marrow Examination ; Conditioning ; Dynamic tests ; Female ; Flow cytometry ; Flow Cytometry - methods ; Hematopoietic Stem Cell Transplantation - methods ; Hematopoietic Stem Cell Transplantation - mortality ; Hematopoietic stem cells ; Hemopoiesis ; Humans ; Leukemia ; Leukemia, Myeloid, Acute - mortality ; Leukemia, Myeloid, Acute - pathology ; Male ; Methods ; Middle Aged ; Multivariate Analysis ; Myeloid leukemia ; Neoplasm, Residual - diagnosis ; Neoplasm, Residual - mortality ; Patient outcomes ; Postoperative Period ; Preoperative Period ; Recurrence ; Remission ; Retrospective Studies ; Risk analysis ; Risk assessment ; Survival ; Survival Rate ; Transplantation ; Transplantation Conditioning ; Transplants & implants ; Treatment Outcome ; Young Adult
Is Part Of: Leukemia, 2016-07, Vol.30 (7), p.1456-1464
Description: Measurable ('minimal') residual disease (MRD) before or after hematopoietic cell transplantation (HCT) identifies adults with AML at risk of poor outcomes. Here, we studied whether peri-transplant MRD dynamics can refine risk assessment. We analyzed 279 adults receiving myeloablative allogeneic HCT in first or second remission who survived at least 35 days and underwent 10-color multiparametric flow cytometry (MFC) analyses of marrow aspirates before and 28±7 days after transplantation. MFC-detectable MRD before (n=63) or after (n=16) transplantation identified patients with high relapse risk and poor survival. Forty-nine patients cleared MRD with HCT conditioning, whereas two patients developed new evidence of disease. The 214 MRD(neg)/MRD(neg) patients had excellent outcomes, whereas both MRD(neg)/MRD(pos) patients died within 100 days following transplantation. For patients with pre-HCT MRD, outcomes were poor regardless of post-HCT MRD status, although survival beyond 3 years was only observed among the 58 patients with decreasing but not the seven patients with increasing peri-HCT MRD levels. In multivariable models, pre-HCT but not post-HCT MRD was independently associated with overall survival and risk of relapse. These data indicate that MRD(pos) patients before transplantation have a high relapse risk regardless of whether or not they clear MFC-detectable disease with conditioning and should be considered for pre-emptive therapeutic strategies.
Publisher: England: Nature Publishing Group
Language: English
Identifier: ISSN: 0887-6924
EISSN: 1476-5551
DOI: 10.1038/leu.2016.46
PMID: 27012865
Source: MEDLINE
ProQuest Central

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Pre- and post-transplant quantification of measurable ('minimal') residual disease via multiparameter flow cytometry in adult acute myeloid leukemia

COPYRIGHT 2016 Nature Publishing Group ;COPYRIGHT 2016 Nature Publishing Group ;Copyright Nature Publishing Group Jul 2016 ;Macmillan Publishers Limited 2016. ;ISSN: 0887-6924 ;EISSN: 1476-5551 ;DOI: 10.1038/leu.2016.46 ;PMID: 27012865

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