Back to Search Start Over

Molecular Detection of Minimal Residual Disease before Allogeneic Stem Cell Transplantation Predicts a High Incidence of Early Relapse in Adult Patients with NPM1 Positive Acute Myeloid Leukemia.

Authors :
Lussana, Federico
Caprioli, Chiara
Stefanoni, Paola
Pavoni, Chiara
Spinelli, Orietta
Buklijas, Ksenija
Michelato, Anna
Borleri, GianMaria
Algarotti, Alessandra
Micò, Caterina
Grassi, Anna
Intermesoli, Tamara
Rambaldi, Alessandro
Source :
Cancers. Oct2019, Vol. 11 Issue 10, p1455. 1p.
Publication Year :
2019

Abstract

We analyzed the impact of alloHSCT in a single center cohort of 89 newly diagnosed NPM1mut AML patients, consecutively treated according to the Northern Italy Leukemia Group protocol 02/06 [NCT00495287]. After two consolidation cycles, the detection of measurable residual disease (MRD) by RQ-PCR was strongly associated with an inferior three-year overall survival (OS, 45% versus 84%, p = 0.001) and disease-free survival (DFS, 44% versus 76%, p = 0.006). In MRD-negative patients, post-remissional consolidation with alloHSCT did not provide a significant additional benefit over a conventional chemotherapy in terms of overall survival [OS, 89% (95% CI 71–100%) versus 81% (95% CI 64–100%), p = 0.59] and disease-free survival [DFS, 80% (95% CI 59–100%) versus 75% (95% CI 56–99%), p = 0.87]. On the contrary, in patients with persistent MRD positivity, the three-year OS and DFS were improved in patients receiving an alloHSCT compared to those allocated to conventional chemotherapy (OS, 52% versus 31%, p = 0.45 and DFS, 50% versus 17%, p = 0.31, respectively). However, in this group of patients, the benefit of alloHSCT was still hampered by a high incidence of leukemia relapse during the first year after transplantation (43%, 95% CI 25–60%). Consolidative alloHSCT improves outcomes compared to standard chemotherapy in patients with persistent NPM1mut MRD positivity, but in these high-risk patients, the significant incidence of leukemia relapse must be tackled by post-transplant preemptive treatments. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20726694
Volume :
11
Issue :
10
Database :
Academic Search Index
Journal :
Cancers
Publication Type :
Academic Journal
Accession number :
139256299
Full Text :
https://doi.org/10.3390/cancers11101455