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
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
收藏
页码:4056 / 4062
页数:7
相关论文
共 30 条
[11]   Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t(8;21): A retrospective study from the European Cooperative Group for Blood and Marrow Transplantation [J].
Gorin, Norbert-Claude ;
Labopin, Myriam ;
Frassoni, Francesco ;
Milpied, Noel ;
Attal, Michel ;
Blaise, Didier ;
Meloni, Giovanna ;
Iori, Anna P. ;
Michallet, Mauricette ;
Willemze, Roel ;
Deconninck, Eric ;
Harousseau, Jean-Luc ;
Polge, Emmanuelle ;
Rocha, Vanderson .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (19) :3183-3188
[12]   The importance of diagnostic cytogenetics on outcome in AML: Analysis of 1,612 patients entered into the MRC AML 10 trial [J].
Grimwade, D ;
Walker, H ;
Oliver, F ;
Wheatley, K ;
Harrison, C ;
Harrison, G ;
Rees, J ;
Hann, I ;
Stevens, R ;
Burnett, A ;
Goldstone, A .
BLOOD, 1998, 92 (07) :2322-2333
[13]   Prospective evaluation of gene mutations and minimal residual disease in patients with core binding factor acute myeloid leukemia [J].
Jourdan, Eric ;
Boissel, Nicolas ;
Chevret, Sylvie ;
Delabesse, Eric ;
Renneville, Aline ;
Cornillet, Pascale ;
Blanchet, Odile ;
Cayuela, Jean-Michel ;
Recher, Christian ;
Raffoux, Emmanuel ;
Delaunay, Jacques ;
Pigneux, Arnaud ;
Bulabois, Claude-Eric ;
Berthon, Celine ;
Pautas, Cecile ;
Vey, Norbert ;
Lioure, Bruno ;
Thomas, Xavier ;
Luquet, Isabelle ;
Terre, Christine ;
Guardiola, Philippe ;
Bene, Marie C. ;
Preudhomme, Claude ;
Ifrah, Norbert ;
Dombret, Herve .
BLOOD, 2013, 121 (12) :2213-2223
[14]   Prognostic value of minimal residual disease quantification by real-time reverse transcriptase polymerase chain reaction in patients with core binding factor leukemias [J].
Krauter, J ;
Görlich, K ;
Ottmann, O ;
Lübbert, M ;
Döhner, H ;
Heit, W ;
Kanz, L ;
Ganser, A ;
Heil, G .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (23) :4413-4422
[15]   Hematopoietic stem cell transplantation for core binding factor acute myeloid leukemia: t(8;21) and inv(16) represent different clinical outcomes [J].
Kuwatsuka, Yachiyo ;
Miyamura, Koichi ;
Suzuki, Ritsuro ;
Kasai, Masaharu ;
Maruta, Atsuo ;
Ogawa, Hiroyasu ;
Tanosaki, Ryuji ;
Takahashi, Satoshi ;
Koda, Kyuhei ;
Yago, Kazuhiro ;
Atsuta, Yoshiko ;
Yoshida, Takashi ;
Sakamaki, Hisashi ;
Kodera, Yoshihisa .
BLOOD, 2009, 113 (09) :2096-2103
[16]   A ≥ 1 log rise in RQ-PCR transcript levels defines molecular relapse in core binding factor acute myeloid leukemia and predicts subsequent morphologic relapse [J].
Lane, Steven ;
Saal, Russell ;
Mollee, Peter ;
Jones, Mark ;
Grigg, Andrew ;
Taylor, Kerry ;
Seymour, John ;
Kennedy, Glen ;
Williams, Bronwyn ;
Grimmett, Karen ;
Griffiths, Vanessa ;
Gill, Devinder ;
Hourigan, Matthew ;
Marlton, Paula .
LEUKEMIA & LYMPHOMA, 2008, 49 (03) :517-523
[17]   Prognostic value of real-time quantitative PCR (RQ-PCR) in AML with t(8;21) [J].
Leroy, H ;
de Botton, S ;
Grardel-Duflos, N ;
Darre, S ;
Leleu, X ;
Roumier, C ;
Morschhauser, F ;
Lai, JL ;
Bauters, F ;
Fenaux, P ;
Preudhomme, C .
LEUKEMIA, 2005, 19 (03) :367-372
[18]  
Liu Yin J. A., 2012, BLOOD, V120, P2826
[19]   Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation [J].
Lu, DP ;
Dong, LJ ;
Wu, T ;
Huang, XJ ;
Zhang, MJ ;
Han, W ;
Chen, H ;
Liu, DH ;
Gao, ZY ;
Chen, YH ;
Xu, LP ;
Zhang, YC ;
Ren, HY ;
Li, D ;
Liu, KY .
BLOOD, 2006, 107 (08) :3065-3073
[20]   Prognostic factors and outcome of core binding factor acute myeloid leukemia patients with t(8;21) differ from those of patients with inv(16):: A cancer and leukemia group B study [J].
Marcucci, G ;
Mrózek, K ;
Ruppert, AS ;
Maharry, K ;
Kolitz, JE ;
Moore, JO ;
Mayer, RJ ;
Pettenati, MJ ;
Powell, BL ;
Edwards, CG ;
Sterling, LJ ;
Vardiman, JW ;
Schiffer, CA ;
Carroll, AJ ;
Larson, RA ;
Bloomfield, CD .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (24) :5705-5717