In children with acute myeloid leukaemia (AML), assessment of initial treatment response is an essential prognostic factor; methods more sensitive than morphology are still under evaluation. We report on the measurement of minimal residual disease (MRD), by multicolour flow-cytometry in one centralized laboratory, in 142 children with newly diagnosed AML enrolled in the Associazione Italiana di EmatoOncologia Pediatrica-AML 2002/01 trial. At the end of the first induction course, MRD was < 0.1% in 69, 0.11% in 16 and > 1% in 51 patients. The 8-year disease-free survival (DFS) of 125 children in morphological complete remission and with MRD < 0.1%, 0.1-1% and >= 1% was 73.1 +/- 5.6%, 37.8 +/- 12.1% and 34.1 +/- 8.8%, respectively (P < 0.01). MRD was also available after the second induction course in 92/142 patients. MRD was >= 0.1% at the end of the first induction course in 36 patients; 13 reached an MRD < 0.1% after the second one and their DFS was 45.4 +/- 16.7% vs. 22.8 +/- 8.9% in patients with persisting MRD >= 0.1% (P = 0.037). Multivariate analysis demonstrated that MRD >= 0.1% after first induction course was, together with a monosomal karyotype, an independent adverse prognostic factor for DFS. Our results show that MRD detected by flow-cytometry after induction therapy predicts outcome in patients with childhood AML and can help stratifying post-remission treatment.
Prognostic significance of flow-cytometry evaluation of minimal residual disease in children with acute myeloid leukaemia treated according to the AIEOP-AML 2002/01 study protocol
Merli, Pietro;
2017-01-01
Abstract
In children with acute myeloid leukaemia (AML), assessment of initial treatment response is an essential prognostic factor; methods more sensitive than morphology are still under evaluation. We report on the measurement of minimal residual disease (MRD), by multicolour flow-cytometry in one centralized laboratory, in 142 children with newly diagnosed AML enrolled in the Associazione Italiana di EmatoOncologia Pediatrica-AML 2002/01 trial. At the end of the first induction course, MRD was < 0.1% in 69, 0.11% in 16 and > 1% in 51 patients. The 8-year disease-free survival (DFS) of 125 children in morphological complete remission and with MRD < 0.1%, 0.1-1% and >= 1% was 73.1 +/- 5.6%, 37.8 +/- 12.1% and 34.1 +/- 8.8%, respectively (P < 0.01). MRD was also available after the second induction course in 92/142 patients. MRD was >= 0.1% at the end of the first induction course in 36 patients; 13 reached an MRD < 0.1% after the second one and their DFS was 45.4 +/- 16.7% vs. 22.8 +/- 8.9% in patients with persisting MRD >= 0.1% (P = 0.037). Multivariate analysis demonstrated that MRD >= 0.1% after first induction course was, together with a monosomal karyotype, an independent adverse prognostic factor for DFS. Our results show that MRD detected by flow-cytometry after induction therapy predicts outcome in patients with childhood AML and can help stratifying post-remission treatment.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
