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

Content Provider	Europe PMC
Author	Zhou, Yi Othus, Megan Araki, Daisuke Wood, Brent L. Radich, Jerald P. Halpern, Anna B. Mielcarek, Marco Estey, Elihu H. Appelbaum, Frederick R. Walter, Roland B.
Abstract	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 2 patients developed new evidence of disease. The 214 MRDneg/MRDneg patients had excellent outcomes, whereas both MRDneg/MRDpos 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 observed among the 58 patients with decreasing but not the 7 patients with increasing peri-HCT MRD levels. In multivariable models, pre-HCT but not post-HCT MRD was independently associated with OS and RR. These data indicate that MRDpos 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.
ISSN	08876924
Journal	Leukemia
Volume Number	30
PubMed Central reference number	PMC4935622
Issue Number	7
PubMed reference number	27012865
e-ISSN	14765551
DOI	10.1038/leu.2016.46
Language	English
Publisher Date	2016-02-29
Access Restriction	Open
Rights License	Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms
Content Type	Text
Resource Type	Article
Subject	Hematology Cancer Research Anesthesiology and Pain Medicine Oncology