title: [Effect of minimal residual disease monitoring by multiparameter flow cytometry pre-conditioning on prognosis of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation].
abstract: Objective:To investigate the effect of minimal residual disease (MRD) monitoring by multiparameter flow cytometry (MFC) pre-conditioning on prognosis of acute myeloid leukemia in first complete remission (CR(1)-AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) , and to explore the value of MRD monitoring by MFC in the prognosis evaluation on allo-HSCT in CR(1)-AML.Methods:Between April 2012 and March 2015, consecutive 186 patients with CR(1)-AML who underwent allo-HSCT were analyzed retrospectively. MRD in BM before conditioning was detected by eight-color MFC. Any level of residual disease was considered to be MRD positive.Results:①Of 186 patients, MRD was negative in 151 patients, positive in 35 patients (<1% in 25 patients and 1% to 3% in 10 patients) . ② With the median follow up of 18 (5-41) months, two-year DFS was 80.0% (95%CI68.5%-92.3%) . Univariate analysis showed that MRD positive patients had lower DFS[62.9% (95%CI50.6%-75.2%)vs88.9% (95%CI76.6%-100.0%) ,P<0.001], higher relapse[11.4% (95%CI4.1%-29.0%)vs3.3% (95%CI0.6%-20.9%) ,P=0.003] and higher NRM [25.7% (95%CI8.1%-43.3%)vs7.9% (95%CI1.3%-26.5%) ,P=0.001] after HSCT compared with that of MRD negative patients. Secondary AML showed lower DFS than primary AML [60.0% (95%CI42.4%-76.6%)vs86.0% (95%CI68.4%-100.0%) ,P=0.004]. ③Multivariate analysis indicated that MRD positive pre-HSCT was the independent risk factor on DFS [HR=4.565 (95%CI2.918-9.482) ,P<0.001], relapse [HR=5.854 (95%CI1.538-22.288) ,P=0.010] and NRM [HR=3.379 (95%CI1.361-8.391) ,P=0.009] after allo-HSCT in CR(1)-AML.Conclusion:MRD positive pre-conditioning was the only negative impact factor for patients with CR(1)-AML after allo-HSCT. MRD by MFC can be used to assess the prognosis of CR(1)-AML after allo-HSCT.
authors.affiliation: Hebei Yanda Lu Daopei Hospital, Langfang 065200, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Lu
authors.forename: T
authors.initials: T
authors.lastname: Wu
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: Y L
authors.initials: YL
authors.lastname: Zhao
authors.forename: X Y
authors.initials: XY
authors.lastname: Cao
authors.forename: D Y
authors.initials: DY
authors.lastname: Liu
authors.forename: J P
authors.initials: JP
authors.lastname: Zhang
authors.forename: M
authors.initials: M
authors.lastname: Xiong
authors.forename: J R
authors.initials: JR
authors.lastname: Zhou
authors.forename: R J
authors.initials: RJ
authors.lastname: Sun
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Wei
authors.forename: S Q
authors.initials: SQ
authors.lastname: Ji
authors.forename: D P
authors.initials: DP
authors.lastname: Lu
mesh_terms: D002908:Chronic Disease; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D055811:Journal Impact Factor; D015470:Leukemia, Myeloid, Acute; D018365:Neoplasm, Residual; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous
keywords: Flow cytometry; Hematopoietic stem cell transplantation; Leukemia, myeloid, acute; Neoplasm, residual