title: Effect of circulating blasts at time of complete remission on subsequent relapse-free survival time in newly diagnosed AML.
abstract: Standardized criteria for complete remission (CR) in acute myeloblastic leukemia (AML) require the absence of peripheral blood blasts (PBBs). However, MD Anderson (MDA) criteria for CR (CR-MDA), although including the other requirements for CR, have not included the PBB count. We exploit this difference to assess the effect of PBBs at the time of CR-MDA on relapse-free survival (RFS) time. Eighty percent of the 533 patients with newly diagnosed AML or refractory anemia with excess of blasts (RAEB) entering CR-MDA from 1995 to 2000 had no PBBs at time of CR-MDA. Ninety-three percent of the remaining patients, who thus had CR-MDA but not standard CR, had 1% to 5% PBBs at this time. Multivariate analyses, using both conventional and Bayesian approaches, indicated that PBBs had no effect on RFS. For all patients and for the subgroups given and not given granulocyte colony-stimulating factor (G-CSF), the 95% credible interval for the relative risk of failure in the PBB group was nearly centered at 1.0. Thus, our data do not support use of PBBs in defining CR in newly diagnosed AML.
authors.affiliation: Department of Leukemia, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 428, Houston, TX 77030, USA. ehestey@mdanderson.org
authors.forename: Elihu H
authors.initials: EH
authors.lastname: Estey
authors.forename: Peter F
authors.initials: PF
authors.lastname: Thall
authors.forename: Xuemei
authors.initials: X
authors.lastname: Wang
authors.forename: Srdan
authors.initials: S
authors.lastname: Verstovsek
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Hagop M
authors.initials: HM
authors.lastname: Kantarjian
mesh_terms: D000754:Anemia, Refractory, with Excess of Blasts / Q000175:diagnosis / Q000473:pathology; D018572:Disease-Free Survival; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000473:pathology*; D015999:Multivariate Analysis; D009360:Neoplastic Cells, Circulating; D017410:Practice Guidelines as Topic; D012074:Remission Induction; D012189:Retrospective Studies