The significance of minimal residual disease kinetics in adults with newly diagnosed PML-RARalpha-positive acute promyelocytic leukemia: results of a prospective trial.
Seventy adults with acute promyelocytic leukemia were studied to clarify the significance of the level and kinetics of minimal residual disease (MRD) over their entire treatment course by realtime quantitative polymerase chain reaction. At a median follow-up of 44 months, nine relapses had occurred. The 5-year probabilities of relapse and disease-free survival were 17.3+/-5.4% and 81.5+/-5.4%, respectively. A MRD level of >10-3 after first consolidation was the most powerful predictor of relapse (85.7+/-13.2% versus 7.3+/-4.1%, p<0.001) and disease-free survival (14.3+/-13.2% versus 91.2%+/-4.3%, p<0.001). Prospective MRD monitoring may allow us to identify subgroups of patients at high risk of relapse earlier during treatment.
Lee
Seok
S
Catholic Hematopoietic Stem Cell Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea. leeseok@catholic.ac.kr
Kim
Yoo-Jin
YJ
Eom
Ki-Seong
KS
Min
Chang-Ki
CK
Kim
Hee-Je
HJ
Cho
Seok-Goo
SG
Lee
Jong-Wook
JW
Min
Woo-Sung
WS
Kim
Chun-Choo
CC
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007700:Kinetics; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D015993:Life Tables; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D009363:Neoplasm Proteins / Q000097:blood; D018365:Neoplasm, Residual; D015514:Oncogene Proteins, Fusion / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012074:Remission Induction; D016019:Survival Analysis; D014212:Tretinoin / Q000008:administration & dosage
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D015514:Oncogene Proteins, Fusion; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; D014212:Tretinoin; D008942:Mitoxantrone; D015122:Mercaptopurine; D008727:Methotrexate; D015255:Idarubicin