TY - JOUR
T1 - Cytogenetic and molecular diagnostic characterization combined to postconsolidation minimal residual disease assessment by flow cytometry improves risk stratification in adult acute myeloid leukemia
AU - Buccisano, Francesco
AU - Maurillo, Luca
AU - Spagnoli, Alessandra
AU - Del Principe, Maria Ilaria
AU - Fraboni, Daniela
AU - Panetta, Paola
AU - Ottone, Tiziana
AU - Consalvo, Maria Irno
AU - Lavorgna, Serena
AU - Bulian, Pietro
AU - Ammatuna, Emanuele
AU - Angelini, Daniela F.
AU - Diamantini, Adamo
AU - Campagna, Selenia
AU - Ottaviani, Licia
AU - Sarlo, Chiara
AU - Gattei, Valter
AU - Del Poeta, Giovanni
AU - Arcese, William
AU - Amadori, Sergio
AU - Lo Coco, Francesco
AU - Venditti, Adriano
PY - 2010/9/30
Y1 - 2010/9/30
N2 - 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.
AB - 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.
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U2 - 10.1182/blood-2009-12-258178
DO - 10.1182/blood-2009-12-258178
M3 - Article
C2 - 20548095
AN - SCOPUS:77957703236
VL - 116
SP - 2295
EP - 2303
JO - Blood
JF - Blood
SN - 0006-4971
IS - 13
ER -