title: MRD parameters using immunophenotypic detection methods are highly reliable in predicting survival in acute myeloid leukaemia.
abstract: Outgrowth of minimal residual disease (MRD) in acute myeloid leukaemia (AML) is responsible for the occurrence of relapses. MRD can be quantified by immunophenotyping on a flow cytometer using the expression of leukaemia-associated phenotypes. MRD was monitored in follow-up samples taken from bone marrow (BM) of 72 patients after three different cycles of chemotherapy and from autologous peripheral blood stem cell (PBSC) products. The MRD% in BM after the first cycle (n=51), second cycle (n=52) and third cycle (n=30), as well as in PBSC products (n=39) strongly correlated with relapse-free survival. At a cutoff level of 1% after the first cycle and median cutoff levels of 0.14% after the second, 0.11% after the third cycle and 0.13% for PBSC products, the relative risk of relapse was a factor 6.1, 3.4, 7.2 and 5.7, respectively, higher for patients in the high MRD group. Also, absolute MRD cell number/ml was highly predictive of the clinical outcome. After the treatment has ended, an increase of MRD% predicted forthcoming relapses, with MRD assessment intervals of < or =3 months. In conclusion, MRD parameter assessment at different stages of disease is highly reliable in predicting survival and forthcoming relapses in AML.
authors.affiliation: Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Feller
authors.forename: M A
authors.initials: MA
authors.lastname: van der Pol
authors.forename: A
authors.initials: A
authors.lastname: van Stijn
authors.forename: G W D
authors.initials: GW
authors.lastname: Weijers
authors.forename: A H
authors.initials: AH
authors.lastname: Westra
authors.forename: B W
authors.initials: BW
authors.lastname: Evertse
authors.forename: G J
authors.initials: GJ
authors.lastname: Ossenkoppele
authors.forename: G J
authors.initials: GJ
authors.lastname: Schuurhuis
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001773:Blood Cells / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012306:Risk; D016019:Survival Analysis