Prognostic significance of flow-cytometry evaluation of minimal residual disease in children with acute myeloid leukaemia treated according to the AIEOP-AML 2002/01 study protocol

Barbara Buldini, Frida Rizzati, Riccardo Masetti, Franca Fagioli, Giuseppe Menna, Concetta Micalizzi, Maria Caterina Putti, Carmelo Rizzari, Nicola Santoro, Marco Zecca, Silvia Disarò, Roberto Rondelli, Pietro Merli, Martina Pigazzi, Andrea Pession, Franco Locatelli, Giuseppe Basso

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Abstract

In children with acute myeloid leukaemia (AML), assessment of initial treatment response is an essential prognostic factor; methods more sensitive than morphology are still under evaluation. We report on the measurement of minimal residual disease (MRD), by multicolour flow-cytometry in one centralized laboratory, in 142 children with newly diagnosed AML enrolled in the Associazione Italiana di EmatoOncologia Pediatrica-AML 2002/01 trial. At the end of the first induction course, MRD was <0·1% in 69, 0·1–1% in 16 and >1% in 51 patients. The 8-year disease-free survival (DFS) of 125 children in morphological complete remission and with MRD <0·1%, 0·1–1% and ≥1% was 73·1 ± 5·6%, 37·8 ± 12·1% and 34·1 ± 8·8%, respectively (P < 0·01). MRD was also available after the second induction course in 92/142 patients. MRD was ≥0·1% at the end of the first induction course in 36 patients; 13 reached an MRD <0·1% after the second one and their DFS was 45·4 ± 16·7% vs. 22·8 ± 8·9% in patients with persisting MRD ≥0·1% (P = 0·037). Multivariate analysis demonstrated that MRD ≥0·1% after first induction course was, together with a monosomal karyotype, an independent adverse prognostic factor for DFS. Our results show that MRD detected by flow-cytometry after induction therapy predicts outcome in patients with childhood AML and can help stratifying post-remission treatment.

Original languageEnglish
Pages (from-to)116-126
Number of pages11
JournalBritish Journal of Haematology
Volume177
Issue number1
DOIs
Publication statusPublished - Apr 1 2017

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Keywords

  • Acute myeloid leukaemia
  • Flow-cytometry
  • Minimal residual disease
  • Paediatric; Risk group

ASJC Scopus subject areas

  • Hematology

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