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

Francesco Buccisano, Luca Maurillo, Alessandra Spagnoli, Maria Ilaria Del Principe, Daniela Fraboni, Paola Panetta, Tiziana Ottone, Maria Irno Consalvo, Serena Lavorgna, Pietro Bulian, Emanuele Ammatuna, Daniela F. Angelini, Adamo Diamantini, Selenia Campagna, Licia Ottaviani, Chiara Sarlo, Valter Gattei, Giovanni Del Poeta, William Arcese, Sergio AmadoriFrancesco Lo Coco, Adriano Venditti

Research output: Contribution to journalArticlepeer-review

Abstract

A total of 143 adult acute myeloid leukemia (AML) patients with available karyotype (K) and FLT3 gene mutational status were assessed for minimal residual disease (MRD) by flow cytometry. Twenty-two (16%) patients had favorable, 115 (80%) intermediate, and 6 (4%) poor risk K; 19 of 129 (15%) carried FLT3-ITD mutation. Considering post-consolidation MRD status, patients with good/intermediate-risk K who were MRD- had 4-year relapse-free survival (RFS) of 70% and 63%, and overall survival (OS) of 84% and 67%, respectively. Patients with good- and intermediate-risk K who were MRD + had 4-year RFS of 15% and 17%, and OS of 38% and 23%, respectively (P <.001 for all comparisons). FLT3 wild-type patients achieving an MRD - status, had a better outcome than those who remained MRD + (4-year RFS, 54% vs 17% P <.001; OS, 60% vs 23%, P = .002). Such an approach redefined cytogenetic/genetic categories in 2 groups: (1) low-risk, including good/intermediate K-MRD- with 4-year RFS and OS of 58% and 73%, respectively; and (2) high risk, including poor-risk K, FLT3-ITD mutated cases, good/intermediate K-MRD+ categories, with RFS and OS of 22% and 17%, respectively (P <.001 for all comparisons). In AML, the integrated evaluation of baseline prognosticators and MRD improves risk-assessment and optimizes postremission therapy.

Original languageEnglish
Pages (from-to)2295-2303
Number of pages9
JournalBlood
Volume116
Issue number13
DOIs
Publication statusPublished - Sep 30 2010

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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