Impact of measurable residual disease by decentralized flow cytometry: a PETHEMA real-world study in 1076 patients with acute myeloid leukemia.

Aged Antineoplastic Combined Chemotherapy Protocols / therapeutic use Combined Modality Therapy Disease Progression Female Flow Cytometry / methods Follow-Up Studies Hematopoietic Stem Cell Transplantation / mortality Humans Induction Chemotherapy / mortality Leukemia, Myeloid, Acute / pathology Male Middle Aged Neoplasm Recurrence, Local / pathology Neoplasm, Residual / pathology Prognosis Registries Survival Rate Transplantation, Homologous

Journal

Leukemia

ISSN: 1476-5551

Titre abrégé: Leukemia

Pays: England

ID NLM: 8704895

Informations de publication

Date de publication:
08 2021

Historique:

received: 23 07 2020

accepted: 07 01 2021

revised: 09 11 2020

pubmed: 3 2 2021

medline: 1 9 2021

entrez: 2 2 2021

Statut: ppublish

Résumé

The role of decentralized assessment of measurable residual disease (MRD) for risk stratification in acute myeloid leukemia (AML) remains largely unknown, and so it does which methodological aspects are critical to empower the evaluation of MRD with prognostic significance, particularly if using multiparameter flow cytometry (MFC). We analyzed 1076 AML patients in first remission after induction chemotherapy, in whom MRD was evaluated by MFC in local laboratories of 60 Hospitals participating in the PETHEMA registry. We also conducted a survey on technical aspects of MRD testing to determine the impact of methodological heterogeneity in the prognostic value of MFC. Our results confirmed the recommended cutoff of 0.1% to discriminate patients with significantly different cumulative-incidence of relapse (-CIR- HR:0.71, P < 0.001) and overall survival (HR: 0.73, P = 0.001), but uncovered the limited prognostic value of MFC based MRD in multivariate and recursive partitioning models including other clinical, genetic and treatment related factors. Virtually all aspects related with methodological, interpretation, and reporting of MFC based MRD testing impacted in its ability to discriminate patients with different CIR. Thus, this study demonstrated that "real-world" assessment of MRD using MFC is prognostic in patients at first remission, and urges greater standardization for improved risk-stratification toward clinical decisions in AML.

Identifiants

DOI: 10.1038/s41375-021-01126-3 PMID: 33526859

pubmed: 33526859

doi: 10.1038/s41375-021-01126-3

pii: 10.1038/s41375-021-01126-3

doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

2358-2370

Subventions

Organisme : Cancer Research UK

Pays : United Kingdom

Informations de copyright

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