Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients

F. Buccisano, L. Maurillo, A. Piciocchi, M. I. Del Principe, C. Sarlo, M. Cefalo, C. Ditto, A. Di Veroli, G. De Santis, M. Irno Consalvo, D. Fraboni, P. Panetta, P. Palomba, C. Attrotto, G. Del Poeta, G. Sconocchia, F. Lo-Coco, S. Amadori, A. Venditti

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Abstract

In the present analysis, we evaluated whether in elderly acute myeloid leukemia (AML) patients (>60 years), minimal residual disease (MRD) assessed by flow cytometry may have a role in guiding choice of postremission strategies. We analyzed 149 young and 61 elderly adults who achieved morphological CR after induction course of EORTC/GIMEMA protocols. Elderly patients reached a postconsolidation MRD negative status less frequently than younger ones (11 vs 28 %, p = 0.009). MRD negativity resulted in a longer 5-year disease-free survival (DFS) both in elderly (57 vs 13 %, p = 0.0197) and in younger patients (56 vs 31 %, p = 0.0017). Accordingly, 5-year cumulative incidence of relapse (CIR) of both elderly (83 vs 42 %, p = 0.045) and younger patients (59 vs 24 % p = NS) who were MRD positive doubled that of MRD negative ones. Nevertheless, CIR of MRD negative elderly patients was twofold higher than that of younger MRD negative ones (42 vs 24 %, p = NS). In conclusion, elderly patients in whom chemotherapy yields a MRD negative CR have duration of DFS and rate of CIR significantly better than those who remain MRD positive. Nonetheless, the high CIR rate observed in the elderly suggests that MRD negativity might have different therapeutic implications in this population than in the younger counterpart.

Original languageEnglish
Pages (from-to)1319-1326
Number of pages8
JournalAnnals of Hematology
Volume94
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

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Residual Neoplasm
Acute Myeloid Leukemia
Recurrence
Incidence
Disease-Free Survival
Flow Cytometry
Survival Rate
Drug Therapy

ASJC Scopus subject areas

  • Medicine(all)

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Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients. / Buccisano, F.; Maurillo, L.; Piciocchi, A.; Del Principe, M. I.; Sarlo, C.; Cefalo, M.; Ditto, C.; Di Veroli, A.; De Santis, G.; Irno Consalvo, M.; Fraboni, D.; Panetta, P.; Palomba, P.; Attrotto, C.; Del Poeta, G.; Sconocchia, G.; Lo-Coco, F.; Amadori, S.; Venditti, A.

In: Annals of Hematology, Vol. 94, No. 8, 01.08.2015, p. 1319-1326.

Research output: Contribution to journalArticle

Buccisano, F, Maurillo, L, Piciocchi, A, Del Principe, MI, Sarlo, C, Cefalo, M, Ditto, C, Di Veroli, A, De Santis, G, Irno Consalvo, M, Fraboni, D, Panetta, P, Palomba, P, Attrotto, C, Del Poeta, G, Sconocchia, G, Lo-Coco, F, Amadori, S & Venditti, A 2015, 'Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients', Annals of Hematology, vol. 94, no. 8, pp. 1319-1326. https://doi.org/10.1007/s00277-015-2364-5
Buccisano, F. ; Maurillo, L. ; Piciocchi, A. ; Del Principe, M. I. ; Sarlo, C. ; Cefalo, M. ; Ditto, C. ; Di Veroli, A. ; De Santis, G. ; Irno Consalvo, M. ; Fraboni, D. ; Panetta, P. ; Palomba, P. ; Attrotto, C. ; Del Poeta, G. ; Sconocchia, G. ; Lo-Coco, F. ; Amadori, S. ; Venditti, A. / Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients. In: Annals of Hematology. 2015 ; Vol. 94, No. 8. pp. 1319-1326.
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T1 - Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients

AU - Buccisano, F.

AU - Maurillo, L.

AU - Piciocchi, A.

AU - Del Principe, M. I.

AU - Sarlo, C.

AU - Cefalo, M.

AU - Ditto, C.

AU - Di Veroli, A.

AU - De Santis, G.

AU - Irno Consalvo, M.

AU - Fraboni, D.

AU - Panetta, P.

AU - Palomba, P.

AU - Attrotto, C.

AU - Del Poeta, G.

AU - Sconocchia, G.

AU - Lo-Coco, F.

AU - Amadori, S.

AU - Venditti, A.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - In the present analysis, we evaluated whether in elderly acute myeloid leukemia (AML) patients (>60 years), minimal residual disease (MRD) assessed by flow cytometry may have a role in guiding choice of postremission strategies. We analyzed 149 young and 61 elderly adults who achieved morphological CR after induction course of EORTC/GIMEMA protocols. Elderly patients reached a postconsolidation MRD negative status less frequently than younger ones (11 vs 28 %, p = 0.009). MRD negativity resulted in a longer 5-year disease-free survival (DFS) both in elderly (57 vs 13 %, p = 0.0197) and in younger patients (56 vs 31 %, p = 0.0017). Accordingly, 5-year cumulative incidence of relapse (CIR) of both elderly (83 vs 42 %, p = 0.045) and younger patients (59 vs 24 % p = NS) who were MRD positive doubled that of MRD negative ones. Nevertheless, CIR of MRD negative elderly patients was twofold higher than that of younger MRD negative ones (42 vs 24 %, p = NS). In conclusion, elderly patients in whom chemotherapy yields a MRD negative CR have duration of DFS and rate of CIR significantly better than those who remain MRD positive. Nonetheless, the high CIR rate observed in the elderly suggests that MRD negativity might have different therapeutic implications in this population than in the younger counterpart.

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