title: Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients.
abstract: In the present analysis, we evaluated whether in elderly acute myeloid leukemia (AML) patients (>60 years), minimal residual disease (MRD) assessed by flow cytometry may have a role in guiding choice of postremission strategies. We analyzed 149 young and 61 elderly adults who achieved morphological CR after induction course of EORTC/GIMEMA protocols. Elderly patients reached a postconsolidation MRD negative status less frequently than younger ones (11 vs 28 %, p = 0.009). MRD negativity resulted in a longer 5-year disease-free survival (DFS) both in elderly (57 vs 13 %, p = 0.0197) and in younger patients (56 vs 31 %, p = 0.0017). Accordingly, 5-year cumulative incidence of relapse (CIR) of both elderly (83 vs 42 %, p = 0.045) and younger patients (59 vs 24 % p = NS) who were MRD positive doubled that of MRD negative ones. Nevertheless, CIR of MRD negative elderly patients was twofold higher than that of younger MRD negative ones (42 vs 24 %, p = NS). In conclusion, elderly patients in whom chemotherapy yields a MRD negative CR have duration of DFS and rate of CIR significantly better than those who remain MRD positive. Nonetheless, the high CIR rate observed in the elderly suggests that MRD negativity might have different therapeutic implications in this population than in the younger counterpart.
authors: Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma "Tor Vergata", Roma, Italia, francesco.buccisano@uniroma2.it.
authors: F
authors: F
authors: Buccisano
authors: L
authors: L
authors: Maurillo
authors: A
authors: A
authors: Piciocchi
authors: M I
authors: MI
authors: Del Principe
authors: C
authors: C
authors: Sarlo
authors: M
authors: M
authors: Cefalo
authors: C
authors: C
authors: Ditto
authors: A
authors: A
authors: Di Veroli
authors: G
authors: G
authors: De Santis
authors: M
authors: M
authors: Irno Consalvo
authors: D
authors: D
authors: Fraboni
authors: P
authors: P
authors: Panetta
authors: P
authors: P
authors: Palomba
authors: C
authors: C
authors: Attrotto
authors: G
authors: G
authors: Del Poeta
authors: G
authors: G
authors: Sconocchia
authors: F
authors: F
authors: Lo-Coco
authors: S
authors: S
authors: Amadori
authors: A
authors: A
authors: Venditti
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D012074:Remission Induction; D055502:Secondary Prevention / Q000379:methods; D055815:Young Adult