Minimal residual disease as biomarker for optimal biologic dosing of ARA-C in patients with acute myeloid leukemia

Luca Maurillo, Francesco Buccisano, Alfonso Piciocchi, Maria Ilaria Del Principe, Chiara Sarlo, Ambra Di Veroli, Paola Panetta, Maria Irno-Consalvo, Daniela Nasso, Concetta Ditto, Marco Refrigeri, Gottardo De Angelis, Raffaella Cerretti, William Arcese, Giuseppe Sconocchia, Francesco Lo-Coco, Sergio Amadori, Adriano Venditti

Research output: Contribution to journalArticle

Abstract

We assessed by flow cytometry minimal residual disease (MRD) in patients with acute myeloid leukemia (AML) given standard-dose (SDAC) and high-dose ARA-C (HDAC) regimens. Of 163 patients enrolled, 130 (median age, 45 years; range, 18-59 years) qualified for analysis, all achieving complete remission after treatment with SDAC (n=78) or HDAC (n=52) plus etoposide and daunorubicin. Consolidation consisted of intermediate-dose ARA-C and daunorubicin. MRD negativity was significantly more frequent in the SDAC vs. HDAC arm after both induction (37% vs. 15%, P=0.007) and consolidation (44% vs. 18%, P=0.002). Respective median residual leukemic cell counts with SDAC and HDAC use were 1.5 × 10-3 and 4 × 10-3 (P=0.033) after induction and 5.7 × 10-4 and 2.9 × 10-3 (P=0.008) after consolidation. Based on ARA-C schedule and post-consolidation MRD status, the four patient groups (SDAC-MRD-, HDAC-MRD-, SDAC-MRD+, and HDAC-MRD+) displayed 5-year overall survival rates of 60%, 33%, 24%, and 42% (P=0.007), respectively, with 24%, 35%, 74%, and 48% (P

Original languageEnglish
Pages (from-to)125-131
Number of pages7
JournalAmerican Journal of Hematology
Volume90
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

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    Maurillo, L., Buccisano, F., Piciocchi, A., Del Principe, M. I., Sarlo, C., Di Veroli, A., Panetta, P., Irno-Consalvo, M., Nasso, D., Ditto, C., Refrigeri, M., De Angelis, G., Cerretti, R., Arcese, W., Sconocchia, G., Lo-Coco, F., Amadori, S., & Venditti, A. (2015). Minimal residual disease as biomarker for optimal biologic dosing of ARA-C in patients with acute myeloid leukemia. American Journal of Hematology, 90(2), 125-131. https://doi.org/10.1002/ajh.23893