Minimal residual disease detected by multiparameter flow cytometry is complementary to genetics for risk stratification treatment in acute myeloid leukemia with biallelic CEBPA mutations
Minimal residual disease detected by multiparameter flow cytometry is complementary to genetics for risk stratification treatment in acute myeloid leukemia with biallelic CEBPA mutations
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DOI：
10.1080/10428194.2019.1576868
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发表时间：
2019-07-29
影响因子：
2.6
通讯作者：
Huang, Xiao-Jun
中科院分区：
文献类型：
--
作者：
Deng, Dao-Xing;Zhu, Hong-Hu;Huang, Xiao-Jun
具有双等位基因CEBPA（bi CEBPA）突变的急性髓性白血病（AML）患者被认为是预后良好的，但其中38-58%仍然复发。因此，识别具有高复发风险的患者非常重要。我们回顾性分析了83例双CEBPA AML。采用多参数流式细胞术（MFC）检测微小残留病（MRD）。巩固化疗期间MRD阳性患者的3年CIR（55% vs. 36.7%; p = 0.037）和RFS（45% vs. 63.3%; p = 0.037）低于MRD阴性患者。在细胞遗传学不良、FLT 3-ITD或MRD阳性的患者中，异基因造血干细胞移植（allo-HSCT）比巩固化疗获得了更上级3年CIR（0% vs. 52.8%; p = 0.006）和RFS（88.9% vs. 47.2%; p = 0.027）。在细胞遗传学中等、FLT 3-ITD阴性和MRD阴性的患者中，巩固化疗维持了相对有利的结局（3年CIR，29%; 3年RFS，71%）。因此，MFC-MRD可以预测复发，并与遗传学互补，用于双CEBPA AML的风险分层治疗。
Acute myeloid leukemia (AML) patients with biallelic CEBPA (bi CEBPA) mutations are considered prognostically favorable, but 38-58% of them still relapse. Therefore, recognizing patients with a high risk of relapse is important. We retrospectively analyzed 83 bi CEBPA AML. Minimal residual disease (MRD) was detected by multiparameter flow cytometry (MFC). Patients with MRD positivity during consolidation chemotherapy had inferior 3-year CIR (55% vs. 36.7%; p = .037) and RFS (45% vs. 63.3%; p = .037) than those with MRD negativity. In patients with adverse cytogenetics, FLT3-ITD or MRD positivity, allogeneic hematopoietic stem cell transplantation (allo-HSCT) achieved superior 3-year CIR (0% vs. 52.8%; p = .006) and RFS (88.9% vs. 47.2%; p = .027) than did consolidation chemotherapy. Consolidation chemotherapy maintained a relatively favorable outcome (3-year CIR, 29%; 3-year RFS, 71%) in patients with intermediate cytogenetics, negative FLT3-ITD, and MRD negativity. Therefore, MFC-MRD could predict relapse and was complementary to genetics for risk stratification treatment in bi CEBPA AML.