Predictive role of minimal residual disease and log clearance in acute myeloid leukemia: A comparison between multiparameter flow cytometry and Wilm's tumor 1 levels

Giovanni Rossi, Maria Marta Minervini, Lorella Melillo, Francesco Di Nardo, Chiara De Waure, Potito Rosario Scalzulli, Gianni Perla, Daniela Valente, Nicola Sinisi, Nicola Cascavilla

Research output: Contribution to journalArticlepeer-review

Abstract

In acute myeloid leukemia (AML), the detection of minimal residual disease (MRD) as well as the degree of log clearance similarly identifies patients with poor prognosis. No comparison was provided between the two approaches in order to identify the best one to monitor follow-up patients. In this study, MRD and clearance were assessed by both multiparameter flow cytometry (MFC) and WT1 expression at different time points on 45 AML patients achieving complete remission. Our results by WT1 expression showed that log clearance lower than 1.96 after induction predicted the recurrence better than MRD higher than 77.0 copies WT1/104 ABL. Conversely, on MFC, MRD higher than 0.2 % after consolidation was more predictive than log clearance below 2.64. At univariate and multivariate analysis, positive MRD values and log clearance below the optimal cutoffs were associated with a shorter disease-free survival (DFS). At the univariate analysis, positive MRD values were also associated with overall survival (OS). Therefore, post-induction log clearance by WT1 and post-consolidation MRD by MFC represented the most informative approaches to identify the relapse. At the optimal timing of assessment, positive MRD and log-clearance values lower than calculated thresholds similarly predicted an adverse prognosis in AML.

Original languageEnglish
Pages (from-to)1149-1157
Number of pages9
JournalAnnals of Hematology
Volume93
Issue number7
DOIs
Publication statusPublished - 2014

Keywords

  • Acute myeloid leukemia
  • Log clearance
  • Minimal residual disease
  • Multiparameter flow cytometry
  • WT1-RNA

ASJC Scopus subject areas

  • Hematology

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