Lijie Han1, Yilu Li2, Jiaying Wu2, Jie Peng3, Xiaolin Han4, Hongmian Zhao5, Chen He6, Yuanyuan Li7, Weimin Wang2, Mengmeng Zhang2, Yafei Li6, Hui Sun2, Haixia Cao2, Li'na Sang2, Zhongxing Jiang2, Jifeng Yu8. 1. Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. hanlijiede@126.com. 2. Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 3. Department of Oncology, The Second Affiliated Hospital of Guizhou Medical University, Kaili, China. 4. Department of Hematology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China. 5. Department of Hematology, Huaihe Hospital of Henan University, Kaifeng, China. 6. Laboratory of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 7. School of Foreign Languages, Henan University of Chinese Medicine, Zhengzhou, China. 8. Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. yujifengzzu@163.com.
Abstract
OBJECTIVES: This study retrospectively investigated in which cycle measurable residual disease (MRD) is associated with prognosis in patients in first complete remission (CR1) of intermediate-risk acute myeloid leukemia (AML). METHODS: The study enrolled 235 younger patients with intermediate-risk AML. MRD was evaluated by multiparameter flow cytometry after the 1st, 2nd, and 3rd chemotherapy cycles (MRD1-3, respectively). RESULTS: No significant association was detected after the 1st and 2nd cycles. However, the 5-year incidence of relapse was higher in the MRD3-positive group (n = 99) than in the negative group (n = 136) (48.7% vs. 13.7%, P = 0.005), while 5-year disease-free survival (DFS) and overall survival (OS) were lower in the MRD3-positive group than in the negative group (43.2% vs. 81.0% and 45.4% vs. 84.1%; P = 0.003 and 0.005, respectively). Allogeneic hematopoietic stem cell transplantation led to a lower 5-year relapse, and higher DFS and OS rates than chemotherapy in the MRD3-positive group (22.3% vs. 71.5%, 65.9% vs. 23.0%, and 67.1% vs. 23.9%; P < 0.001, 0.002, and 0.022, respectively), but did not affect the MRD-negative group. CONCLUSIONS: MRD3 could serve as an indicator for post-remission treatment choice and help improve outcomes for intermediate-risk AML in CR1.
OBJECTIVES: This study retrospectively investigated in which cycle measurable residual disease (MRD) is associated with prognosis in patients in first complete remission (CR1) of intermediate-risk acute myeloid leukemia (AML). METHODS: The study enrolled 235 younger patients with intermediate-risk AML. MRD was evaluated by multiparameter flow cytometry after the 1st, 2nd, and 3rd chemotherapy cycles (MRD1-3, respectively). RESULTS: No significant association was detected after the 1st and 2nd cycles. However, the 5-year incidence of relapse was higher in the MRD3-positive group (n = 99) than in the negative group (n = 136) (48.7% vs. 13.7%, P = 0.005), while 5-year disease-free survival (DFS) and overall survival (OS) were lower in the MRD3-positive group than in the negative group (43.2% vs. 81.0% and 45.4% vs. 84.1%; P = 0.003 and 0.005, respectively). Allogeneic hematopoietic stem cell transplantation led to a lower 5-year relapse, and higher DFS and OS rates than chemotherapy in the MRD3-positive group (22.3% vs. 71.5%, 65.9% vs. 23.0%, and 67.1% vs. 23.9%; P < 0.001, 0.002, and 0.022, respectively), but did not affect the MRD-negative group. CONCLUSIONS: MRD3 could serve as an indicator for post-remission treatment choice and help improve outcomes for intermediate-risk AML in CR1.
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