Author
Listed:
- Mingming Zhang
- Huarui Fu
- Xiaoyu Lai
- Yamin Tan
- Weiyan Zheng
- Jimin Shi
- Yanmin Zhao
- Maofang Lin
- Jingsong He
- Zhen Cai
- Yi Luo
- He Huang
Abstract
We evaluated the prognostic effect of minimal residual disease at first achievement of complete remission (MRD at CR1) in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia (ALL). A total of 97 patients received treatment in our center between 2007 and 2012 were retrospectively reviewed in this study. Patients were divided into two arms according to the post-remission therapy (chemotherapy alone or allogeneic hematopoietic stem cell transplantation (allo-HSCT)) they received. MRD was detected by four-color flow cytometry. We chose 0.02% and 0.2% as the cut-off points of MRD at CR1 for risk stratification using receiver operating characteristic analysis. The 3-year overall survival (OS) and leukemia free survival (LFS) rates for the whole cohort were 46.2% and 40.5%. MRD at CR1 had a significantly negative correlation with survival in both arms. Three-year OS rates in the chemotherapy arm were 70.0%, 25.2%, 0% (P = 0.003) for low, intermediate, and high levels of MRD at CR1, respectively. Three-year OS rates in the transplant arm were 81.8%, 64.3%, 27.3% (P = 0.005) for low, intermediate, and high levels of MRD at CR1, respectively. Multivariate analysis confirmed that higher level of MRD at CR1 was a significant adverse factor for OS and LFS. Compared with chemotherapy alone, allo-HSCT significantly improved LFS rates in patients with intermediate (P = 0.005) and high (P = 0.022) levels of MRD at CR1, but not patients with low level of MRD at CR1 (P = 0.851). These results suggested that MRD at CR1 could strongly predict the outcome of adult ALL. Patients with intermediate and high levels of MRD at CR1 would benefit from allo-HSCT.
Suggested Citation
Mingming Zhang & Huarui Fu & Xiaoyu Lai & Yamin Tan & Weiyan Zheng & Jimin Shi & Yanmin Zhao & Maofang Lin & Jingsong He & Zhen Cai & Yi Luo & He Huang, 2016.
"Minimal Residual Disease at First Achievement of Complete Remission Predicts Outcome in Adult Patients with Philadelphia Chromosome-Negative Acute Lymphoblastic Leukemia,"
PLOS ONE, Public Library of Science, vol. 11(10), pages 1-11, October.
Handle:
RePEc:plo:pone00:0163599
DOI: 10.1371/journal.pone.0163599
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