MRD-directed risk stratification treatment may improve outcomes of t(8;21) AML in the first complete remission: results from the AML05 multicenter trial

被引：276

作者：

Zhu, Hong-Hu ^{[1
]}

Zhang, Xiao-Hui ^{[1
]}

Qin, Ya-Zhen ^{[1
]}

Liu, Dai-Hong ^{[1
]}

Jiang, Hao ^{[1
]}

Chen, Huan ^{[1
]}

Jiang, Qian ^{[1
]}

Xu, Lan-Ping ^{[1
]}

Lu, Jin ^{[1
]}

Han, Wei ^{[1
]}

Bao, Li ^{[1
]}

Wang, Yu ^{[1
]}

Chen, Yu-Hong ^{[1
]}

Wang, Jing-Zhi ^{[1
]}

Wang, Feng-Rong ^{[1
]}

Lai, Yue-Yun ^{[1
]}

Chai, Jun-Yue ^{[2
]}

Wang, Li-Ru ^{[3
]}

Liu, Yan-Rong ^{[1
]}

Liu, Kai-Yan ^{[1
]}

Jiang, Bin ^{[1
]}

Huang, Xiao-Jun ^{[1
,4
]}

机构：

[1] Peking Univ, Inst Hematol, Peking Univ Peoples Hosp, Beijing 10044, Peoples R China

[2] Beijing 6 Hosp, Beijing, Peoples R China

[3] Beijing Rehabil Hosp, Beijing, Peoples R China

[4] Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China

来源：

BLOOD | 2013年 / 121卷 / 20期

基金：

中国国家自然科学基金;

关键词：

ACUTE MYELOID-LEUKEMIA; MINIMAL RESIDUAL DISEASE; STEM-CELL TRANSPLANTATION; PROGNOSTIC VALUE; MARROW-TRANSPLANTATION; AML1-ETO-POSITIVE AML; KIT MUTATIONS; GROUP-B; RQ-PCR; INV(16);

D O I：

10.1182/blood-2012-11-468348

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We aimed to improve the outcome of t(8;21) acute myeloid leukemia (AML) in the first complete remission (CR1) by applying risk-directed therapy based on minimal residual disease (MRD) determined by RUNX1/RUNX1T1 transcript levels. Risk-directed therapy included recommending allogeneic hematopoietic stem cell transplantation (allo-HSCT) for high-risk patients and chemotherapy/autologous-HSCT (auto-HSCT) for low-risk patients. Among 116 eligible patients, MRD status after the second consolidation rather than induction or first consolidation could discriminate high-risk relapse patients (P = .001). Allo-HSCT could reduce relapse and improve survival compared with chemotherapy for high-risk patients (cumulative incidence of relapse [CIR]: 22.1% vs 78.9%, P < .0001; disease-free survival [DFS]: 61.7% vs 19.6%, P = .001), whereas chemotherapy/auto-HSCT achieved a low relapse rate (5.3%) and high DFS (94.7%) for low-risk patients. Multivariate analysis revealed that MRD status and treatment choice were independent prognostic factors for relapse, DFS, and OS. We concluded that MRD status after the second consolidation may be the best timing for treatment choice. MRD-directed risk stratification treatment may improve the outcome of t(8; 21) AML in CR1. This trial was registered at http://www.chictr.orgas #ChiCTR-OCH-12002406.

引用

页码：4056 / 4062

页数：7

共 30 条

[1]

Alonzo TA, 2010, BLOOD, V116, P761

[2] ANALYSIS OF SURVIVAL BY TUMOR RESPONSE [J].

ANDERSON, JR ;

CAIN, KC ;

GELBER, RD .

JOURNAL OF CLINICAL ONCOLOGY, 1983, 1 (11) :710-719

[3] The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations [J].

Appelbaum, Frederick R. ;

Kopecky, Kenneth J. ;

Tallman, Martin S. ;

Slovak, Marilyn L. ;

Gundacker, Holly M. ;

Kim, Haesook T. ;

Dewald, Gordon W. ;

Kantarjian, Hagop M. ;

Pierce, Sherry R. ;

Estey, Elihu H. .

BRITISH JOURNAL OF HAEMATOLOGY, 2006, 135 (02) :165-173

[4] Prognostic and therapeutic implications of minimal residual disease detection in acute myeloid leukemia [J].

Buccisano, Francesco ;

Maurillo, Luca ;

Del Principe, Maria Ilaria ;

Del Poeta, Giovanni ;

Sconocchia, Giuseppe ;

Lo-Coco, Francesco ;

Arcese, William ;

Amadori, Sergio ;

Venditti, Adriano .

BLOOD, 2012, 119 (02) :332-341

[5] Cytogenetic and molecular diagnostic characterization combined to postconsolidation minimal residual disease assessment by flow cytometry improves risk stratification in adult acute myeloid leukemia [J].

Buccisano, Francesco ;

Maurillo, Luca ;

Spagnoli, Alessandra ;

Del Principe, Maria Ilaria ;

Fraboni, Daniela ;

Panetta, Paola ;

Ottone, Tiziana ;

Consalvo, Maria Irno ;

Lavorgna, Serena ;

Bulian, Pietro ;

Ammatuna, Emanuele ;

Angelini, Daniela F. ;

Diamantini, Adamo ;

Campagna, Selenia ;

Ottaviani, Licia ;

Sarlo, Chiara ;

Gattei, Valter ;

Del Poeta, Giovanni ;

Arcese, William ;

Amadori, Sergio ;

Lo Coco, Francesco ;

Venditti, Adriano .

BLOOD, 2010, 116 (13) :2295-2303

[6] Patients with t(8;21)(q22;q22) and acute myeloid leukemia have superior failure-free and overall survival when repetitive cycles of high-dose cytarabine are administered [J].

Byrd, JC ;

Dodge, RK ;

Carroll, A ;

Baer, MR ;

Edwards, C ;

Stamberg, J ;

Qumsiyeh, M ;

Moore, JO ;

Mayer, RJ ;

Davey, F ;

Schiffer, CA ;

Bloomfield, CD .

JOURNAL OF CLINICAL ONCOLOGY, 1999, 17 (12) :3767-3775

[7] Prognostic impact of c-KIT mutations in core binding factor leukemas:: an Italian retrospective study [J].

Cairoli, R ;

Beghini, A ;

Grillo, G ;

Nadali, G ;

Elice, F ;

Ripamonti, CB ;

Colapietro, P ;

Nichelatti, M ;

Pezzetti, L ;

Lunghi, M ;

Cuneo, A ;

Viola, A ;

Ferrara, F ;

Lazzarino, M ;

Rodeghiero, F ;

Pizzolo, G ;

Larizza, L ;

Morra, E .

BLOOD, 2006, 107 (09) :3463-3468

[8] Determination of minimal residual disease in leukaemia patients [J].

Campana, D .

BRITISH JOURNAL OF HAEMATOLOGY, 2003, 121 (06) :823-838

[9] DETECTION OF MINIMAL RESIDUAL DISEASE IN ACUTE-LEUKEMIA - METHODOLOGIC ADVANCES AND CLINICAL-SIGNIFICANCE [J].

CAMPANA, D ;

PUI, CH .

BLOOD, 1995, 85 (06) :1416-1434

[10] Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet [J].

Doehner, Hartmut ;

Estey, Elihu H. ;

Amadori, Sergio ;

Appelbaum, Frederick R. ;

Buechner, Thomas ;

Burnett, Alan K. ;

Dombret, Herve ;

Fenaux, Pierre ;

Grimwade, David ;

Larson, Richard A. ;

Lo-Coco, Francesco ;

Naoe, Tomoki ;

Niederwieser, Dietger ;

Ossenkoppele, Gert J. ;

Sanz, Miguel A. ;

Sierra, Jorge ;

Tallman, Martin S. ;

Loewenberg, Bob ;

Bloomfield, Clara D. .

BLOOD, 2010, 115 (03) :453-474

← 1 2 3 →