Post-Transplantation Multicolored Flow Cytometry-Minimal Residual Disease Status on Day 100 Predicts Outcomes for Patients With Refractory Acute Myeloid Leukemia

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Post-Transplantation Multicolored Flow Cytometry-Minimal Residual Disease Status on Day 100 Predicts Outcomes for Patients With Refractory Acute Myeloid Leukemia. / Klyuchnikov, Evgeny; Badbaran, Anita; Massoud, Radwan; Fritsche-Friedland, Ulrike; Janson, Dietlinde; Ayuk, Francis; Christopeit, Maximilian; Wolschke, Christine; Bacher, Ulrike; Kröger, Nicolaus.

in: TRANSPL CELL THER, Jahrgang 28, Nr. 5, 05.2022, S. 267.e1-267.e7.

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@article{b19761fd8a1d4c579817c117be7395f1,
title = "Post-Transplantation Multicolored Flow Cytometry-Minimal Residual Disease Status on Day 100 Predicts Outcomes for Patients With Refractory Acute Myeloid Leukemia",
abstract = "Patients with relapsed/refractory acute myeloid leukemia (AML) have a dismal prognosis. Allogeneic stem cell transplantation (allo-SCT) provides a curative approach; however, the overall survival (OS) remains low (20% to 40%). In this setting, although some effective approaches have been evaluated in recent years, the management of such patients still remains challenging. In this study we evaluated the predictive role of post-transplant day 100 minimal residual disease (MRD) detection for post-transplantation outcomes for patients with refractory AML. Fifty-six adult patients with refractory AML (median age 58, range 20-76; male, 61%) who underwent allo-SCT were included in this retrospective monocentric study. Twenty-nine patients (52%) received fludarabine, amsacrine, and cytarabine (FLAMSA)-based conditioning. MRD was assessed using multicolored flow cytometry (MFC) according to European Leukemia Net guidelines ({"}different from normal{"} and leukemia-associated phenotype). The sensitivity of the method was 10-4 to 10-5. The median marrow blast count at allo-SCT was 25% (range 6% to 91%). At day 100 after transplantation, 40 patients (71%) experienced MFC-MRD negativity, and 16 patients (29%) were MRD positive. All included patients survived at least 100 days after transplantation without relapse. Univariate and multivariate analysis based on Kaplan-Meier and Cox proportional hazards method were performed. The median follow-up was 16 months (range 3 to 66). The post-transplantation day 100 MRD-negative patients instead received 2 allografts (27% versus 6%, P = .08). In multivariate analysis, day 100 MRD status (negative versus positive) (OS: 0.23 [0.1 to 0.54], P =0.001; relapses: 0.20 [0.1 to 0.49], P = .0005) and FLAMSA versus other regimens (0.34 [0.1 to 0.83], P = .018; relapses: 0.43 [0.17 to 1.1], P = .07) independently impacted post-transplantation survival. We suggest that post-transplantation day 100 MFC-MRD detection plays predictive role in refractory AML patients and may help to define possible candidates for early post-transplantation interventions aiming to decrease the relapse risk and improve survival.",
author = "Evgeny Klyuchnikov and Anita Badbaran and Radwan Massoud and Ulrike Fritsche-Friedland and Dietlinde Janson and Francis Ayuk and Maximilian Christopeit and Christine Wolschke and Ulrike Bacher and Nicolaus Kr{\"o}ger",
note = "Copyright {\textcopyright} 2022. Published by Elsevier Inc.",
year = "2022",
month = may,
doi = "10.1016/j.jtct.2022.01.014",
language = "English",
volume = "28",
pages = "267.e1--267.e7",
journal = "TRANSPL CELL THER",
issn = "2666-6375",
publisher = "Elsevier BV",
number = "5",

}

RIS

TY - JOUR

T1 - Post-Transplantation Multicolored Flow Cytometry-Minimal Residual Disease Status on Day 100 Predicts Outcomes for Patients With Refractory Acute Myeloid Leukemia

AU - Klyuchnikov, Evgeny

AU - Badbaran, Anita

AU - Massoud, Radwan

AU - Fritsche-Friedland, Ulrike

AU - Janson, Dietlinde

AU - Ayuk, Francis

AU - Christopeit, Maximilian

AU - Wolschke, Christine

AU - Bacher, Ulrike

AU - Kröger, Nicolaus

N1 - Copyright © 2022. Published by Elsevier Inc.

PY - 2022/5

Y1 - 2022/5

N2 - Patients with relapsed/refractory acute myeloid leukemia (AML) have a dismal prognosis. Allogeneic stem cell transplantation (allo-SCT) provides a curative approach; however, the overall survival (OS) remains low (20% to 40%). In this setting, although some effective approaches have been evaluated in recent years, the management of such patients still remains challenging. In this study we evaluated the predictive role of post-transplant day 100 minimal residual disease (MRD) detection for post-transplantation outcomes for patients with refractory AML. Fifty-six adult patients with refractory AML (median age 58, range 20-76; male, 61%) who underwent allo-SCT were included in this retrospective monocentric study. Twenty-nine patients (52%) received fludarabine, amsacrine, and cytarabine (FLAMSA)-based conditioning. MRD was assessed using multicolored flow cytometry (MFC) according to European Leukemia Net guidelines ("different from normal" and leukemia-associated phenotype). The sensitivity of the method was 10-4 to 10-5. The median marrow blast count at allo-SCT was 25% (range 6% to 91%). At day 100 after transplantation, 40 patients (71%) experienced MFC-MRD negativity, and 16 patients (29%) were MRD positive. All included patients survived at least 100 days after transplantation without relapse. Univariate and multivariate analysis based on Kaplan-Meier and Cox proportional hazards method were performed. The median follow-up was 16 months (range 3 to 66). The post-transplantation day 100 MRD-negative patients instead received 2 allografts (27% versus 6%, P = .08). In multivariate analysis, day 100 MRD status (negative versus positive) (OS: 0.23 [0.1 to 0.54], P =0.001; relapses: 0.20 [0.1 to 0.49], P = .0005) and FLAMSA versus other regimens (0.34 [0.1 to 0.83], P = .018; relapses: 0.43 [0.17 to 1.1], P = .07) independently impacted post-transplantation survival. We suggest that post-transplantation day 100 MFC-MRD detection plays predictive role in refractory AML patients and may help to define possible candidates for early post-transplantation interventions aiming to decrease the relapse risk and improve survival.

AB - Patients with relapsed/refractory acute myeloid leukemia (AML) have a dismal prognosis. Allogeneic stem cell transplantation (allo-SCT) provides a curative approach; however, the overall survival (OS) remains low (20% to 40%). In this setting, although some effective approaches have been evaluated in recent years, the management of such patients still remains challenging. In this study we evaluated the predictive role of post-transplant day 100 minimal residual disease (MRD) detection for post-transplantation outcomes for patients with refractory AML. Fifty-six adult patients with refractory AML (median age 58, range 20-76; male, 61%) who underwent allo-SCT were included in this retrospective monocentric study. Twenty-nine patients (52%) received fludarabine, amsacrine, and cytarabine (FLAMSA)-based conditioning. MRD was assessed using multicolored flow cytometry (MFC) according to European Leukemia Net guidelines ("different from normal" and leukemia-associated phenotype). The sensitivity of the method was 10-4 to 10-5. The median marrow blast count at allo-SCT was 25% (range 6% to 91%). At day 100 after transplantation, 40 patients (71%) experienced MFC-MRD negativity, and 16 patients (29%) were MRD positive. All included patients survived at least 100 days after transplantation without relapse. Univariate and multivariate analysis based on Kaplan-Meier and Cox proportional hazards method were performed. The median follow-up was 16 months (range 3 to 66). The post-transplantation day 100 MRD-negative patients instead received 2 allografts (27% versus 6%, P = .08). In multivariate analysis, day 100 MRD status (negative versus positive) (OS: 0.23 [0.1 to 0.54], P =0.001; relapses: 0.20 [0.1 to 0.49], P = .0005) and FLAMSA versus other regimens (0.34 [0.1 to 0.83], P = .018; relapses: 0.43 [0.17 to 1.1], P = .07) independently impacted post-transplantation survival. We suggest that post-transplantation day 100 MFC-MRD detection plays predictive role in refractory AML patients and may help to define possible candidates for early post-transplantation interventions aiming to decrease the relapse risk and improve survival.

U2 - 10.1016/j.jtct.2022.01.014

DO - 10.1016/j.jtct.2022.01.014

M3 - SCORING: Journal article

C2 - 35066212

VL - 28

SP - 267.e1-267.e7

JO - TRANSPL CELL THER

JF - TRANSPL CELL THER

SN - 2666-6375

IS - 5

ER -