Changes in magnetic resonance bone marrow angiogenesis on day 7 after induction chemotherapy can predict outcome of acute myeloid leukemia.
Recently, dynamic contrast-enhanced magnetic resonance imaging has been shown to be a non-invasive technique that provides global and functional imaging of bone marrow angiogenesis in acute myeloid leukemia. To assess the clinical implication of changes in angiogenesis shortly after induction chemotherapy, dynamic contrast-enhanced magnetic resonance imaging was performed prospectively before treatment (day 0) and on day 7 in 80 patients with de novo acute myeloid leukemia. We demonstrated that a post-therapeutic reduction in Peak (negative DeltaPeak) compared with the day 0 value was significantly associated with a higher chance of achieving complete remission, and better overall and disease free survival (P=0.022, 0.003 and 0.007, respectively). Cox's multivariate analysis also identified negative DeltaPeak value as an independent good prognostic factor for overall and disease free survival. Our findings provide evidence that the change of Peak on day 7 relative to pre-treatment levels may be a relevant biomarker for early identification of patients who may fail conventional induction chemotherapy (ClinicalTrials.gov Identifier: NCT00172562).
Hou
Hsin-An
HA
Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. hftien@ntu.edu.tw
Shih
Tiffany Ting-Fang
TT
Liu
Chieh-Yu
CY
Chen
Bang-Bin
BB
Tang
Jih-Luh
JL
Yao
Ming
M
Huang
Shang-Yi
SY
Chou
Wen-Chien
WC
Hsu
Chao-Yu
CY
Tien
Hwei-Fang
HF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000098:blood supply; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult