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Article: Comparative analysis of different approaches to measure treatment response in acute myeloid leukemia

TitleComparative analysis of different approaches to measure treatment response in acute myeloid leukemia
Authors
Issue Date2012
Citation
Journal of Clinical Oncology, 2012, v. 30, n. 29, p. 3625-3632 How to Cite?
AbstractPurpose: In acute myeloid leukemia (AML), initial treatment response by morphologic analysis of bone marrow predicts long-term outcome. Response can now be assessed by minimal residual disease (MRD) monitoring with flow cytometry or polymerase chain reaction (PCR). We determined the relation among the results of these approaches and their prognostic value. Patients and Methods: In the multicenter AML02 study, follow-up bone marrow samples from 203 children and adolescents with newly diagnosed AML were examined by flow cytometry (n = 1,514), morphology (n = 1,382), and PCR amplification of fusion transcripts (n = 508). Results were correlated with treatment outcome. Results: Among 1,215 samples with less than 5% leukemic myeloblasts by morphology, 100 (8.2%) were MRD positive (≥ 0.1%) by flow cytometry, whereas 96 (57.5%) of the 167 samples with ≥ 5% blasts were MRD negative. Virtually all (308 of 311; 99.0%) MRD-negative samples by PCR were also MRD negative by flow cytometry. However, only 19 (9.6%) of the 197 PCR-positive samples were flow cytometry positive, with analyses of AML1-ETO and CBFβ-MYH11 accounting for most discrepancies, whereas eight of 13 MLL-positive samples had detectable MRD by flow cytometry. MRD by flow cytometry after induction 1 or 2 predicted lower event-free survival and higher relapse rate (P < .001) and was an independent prognostic factor in a multivariable analysis; prediction was not improved by morphologic information or molecular findings. Conclusion: In childhood AML, morphologic assessment of treatment response has limited value if MRD is measured by flow cytometry. MLL fusion transcripts can provide prognostic information in some patients, whereas monitoring of AML1-ETO and CBFβ-MYH11 transcripts is largely uninformative. © 2012 by American Society of Clinical Oncology.
Persistent Identifierhttp://hdl.handle.net/10722/294491
ISSN
2020 Impact Factor: 44.544
2015 SCImago Journal Rankings: 9.204
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorInaba, Hiroto-
dc.contributor.authorCoustan-Smith, Elaine-
dc.contributor.authorCao, Xueyuan-
dc.contributor.authorPounds, Stanley B.-
dc.contributor.authorShurtleff, Sheila A.-
dc.contributor.authorWang, Kathleen Y.-
dc.contributor.authorRaimondi, Susana C.-
dc.contributor.authorOnciu, Mihaela-
dc.contributor.authorJacobsen, Jeffrey-
dc.contributor.authorRibeiro, Raul C.-
dc.contributor.authorDahl, Gary V.-
dc.contributor.authorBowman, W. Paul-
dc.contributor.authorTaub, Jeffrey W.-
dc.contributor.authorDegar, Barbara-
dc.contributor.authorLeung, Wing-
dc.contributor.authorDowning, James R.-
dc.contributor.authorPui, Ching Hon-
dc.contributor.authorRubnitz, Jeffrey E.-
dc.contributor.authorCampana, Dario-
dc.date.accessioned2020-12-03T08:22:51Z-
dc.date.available2020-12-03T08:22:51Z-
dc.date.issued2012-
dc.identifier.citationJournal of Clinical Oncology, 2012, v. 30, n. 29, p. 3625-3632-
dc.identifier.issn0732-183X-
dc.identifier.urihttp://hdl.handle.net/10722/294491-
dc.description.abstractPurpose: In acute myeloid leukemia (AML), initial treatment response by morphologic analysis of bone marrow predicts long-term outcome. Response can now be assessed by minimal residual disease (MRD) monitoring with flow cytometry or polymerase chain reaction (PCR). We determined the relation among the results of these approaches and their prognostic value. Patients and Methods: In the multicenter AML02 study, follow-up bone marrow samples from 203 children and adolescents with newly diagnosed AML were examined by flow cytometry (n = 1,514), morphology (n = 1,382), and PCR amplification of fusion transcripts (n = 508). Results were correlated with treatment outcome. Results: Among 1,215 samples with less than 5% leukemic myeloblasts by morphology, 100 (8.2%) were MRD positive (≥ 0.1%) by flow cytometry, whereas 96 (57.5%) of the 167 samples with ≥ 5% blasts were MRD negative. Virtually all (308 of 311; 99.0%) MRD-negative samples by PCR were also MRD negative by flow cytometry. However, only 19 (9.6%) of the 197 PCR-positive samples were flow cytometry positive, with analyses of AML1-ETO and CBFβ-MYH11 accounting for most discrepancies, whereas eight of 13 MLL-positive samples had detectable MRD by flow cytometry. MRD by flow cytometry after induction 1 or 2 predicted lower event-free survival and higher relapse rate (P < .001) and was an independent prognostic factor in a multivariable analysis; prediction was not improved by morphologic information or molecular findings. Conclusion: In childhood AML, morphologic assessment of treatment response has limited value if MRD is measured by flow cytometry. MLL fusion transcripts can provide prognostic information in some patients, whereas monitoring of AML1-ETO and CBFβ-MYH11 transcripts is largely uninformative. © 2012 by American Society of Clinical Oncology.-
dc.languageeng-
dc.relation.ispartofJournal of Clinical Oncology-
dc.titleComparative analysis of different approaches to measure treatment response in acute myeloid leukemia-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1200/JCO.2011.41.5323-
dc.identifier.pmid22965955-
dc.identifier.pmcidPMC3462046-
dc.identifier.scopuseid_2-s2.0-84867603927-
dc.identifier.volume30-
dc.identifier.issue29-
dc.identifier.spage3625-
dc.identifier.epage3632-
dc.identifier.eissn1527-7755-
dc.identifier.isiWOS:000309653600013-
dc.identifier.f1000718874815-
dc.identifier.issnl0732-183X-

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