Comparison of minimal residual disease as outcome predictor for AML patients in first complete remission undergoing myeloablative or nonmyeloablative allogeneic hematopoietic cell transplantation

被引：195

作者：

Walter, R. B. ^{[1
,2
,3
]}

Gyurkocza, B. ^{[1
,4
]}

Storer, B. E. ^{[1
]}

Godwin, C. D. ^{[5
]}

Pagel, J. M. ^{[1
]}

Buckley, S. A. ^{[5
]}

Sorror, M. L. ^{[1
,4
]}

Wood, B. L. ^{[6
]}

Storb, R. ^{[1
]}

Appelbaum, F. R. ^{[1
,4
]}

Sandmaier, B. M. ^{[1
,4
]}

机构：

[1] Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98109 USA

[2] Univ Washington, Dept Med, Div Hematol, Seattle, WA 98195 USA

[3] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[4] Univ Washington, Dept Med, Div Med Oncol, Seattle, WA 98109 USA

[5] Univ Washington, Dept Med, Residency Program, Seattle, WA 98109 USA

[6] Univ Washington, Dept Lab Med, Div Hematopathol, Seattle, WA 98195 USA

来源：

LEUKEMIA | 2015年 / 29卷 / 01期

基金：

美国国家卫生研究院;

关键词：

ACUTE MYELOID-LEUKEMIA; VERSUS-HOST-DISEASE; LONG-TERM SURVIVAL; WORKING PARTY; CHILDREN; IMPACT; DIAGNOSIS; ADULTS; BLOOD; DONOR;

D O I：

10.1038/leu.2014.173

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Minimal residual disease (MRD) is associated with adverse outcome in acute myeloid leukemia (AML) after myeloablative (MA) hematopoietic cell transplantation (HCT). We compared this association with that seen after nonmyeloablative (NMA) conditioning in 241 adults receiving NMA (n = 86) or MA (n = 155) HCT for AML in first remission with pre-HCT bone marrow aspirates assessed by flow cytometry. NMA patients were older and had more comorbidities and secondary leukemias. Three-year relapse estimates were 28% and 57% for MRDneg and MRDpos NMA patients, and 22% and 63% for MA patients. Three-year overall survival (OS) estimates were 48% and 41% for MRDneg and MRDpos NMA patients and 76% and 25% for MA patients. This similar OS after NMA conditioning was largely accounted for by higher non-relapse mortality (NRM) in MRDneg (30%) compared with MRDpos (10%) patients, whereas the reverse was found for MRDneg (7%) and MRDpos (23%) MA patients. A statistically significant difference between MA and NMA patients in the association of MRD with OS (P=0.001) and NRM (P = 0.002) but not relapse (P = 0.17) was confirmed. After adjustment, the risk of relapse was 4.51 times (P=0.001) higher for MRDpos patients. These data indicate that the negative impact of MRD on relapse risk is similar after NMA and MA conditioning.

引用

页码：137 / 144

页数：8

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