Presence of minimal residual disease (MRD) in acute myelogenous leukemia (AML) patients preallogeneic bone marrow transplantation (BMT) is associated with a lower relapse-free survival (RFS)

H. K. Holland, R. A. Brav, K. Otoole, J. T. Holden, P. O. Connaghan, L. T. Heffiier, E. K. Waller, E. F. Winton, Andrew M Yeager

Research output: Contribution to journalArticle

Abstract

We evaluated whether the presence of MRD detected by flow cytometry pre-BMT in patients (pts) with AML who were in complete remission (CR) by morphologic criteria was associated with an increased relapse rate after related allogeneic HLA-identical BMT Twenty-eight consecutive pts who had undergone allogeneic BMT with a median follow up of 31 months, (range, 10-64) were evaluated. The treatment regimen was either busulfan (Bu) and Cyclophosphamide (Cy) (n=2) or Bu, Cy and cytarabine (n=26). Twenty-one patients were in first CR (CRI) and 7 were in CR2. Disease status by FAB classification were 4 MO, 5 Ml, 7 M2, 3 M3, 6 M4, 1 M5, 1 M6 and I unclassified. Their median age was 46 yr (range, 20-62). All pts had bone marrow aspirates performed within 4 weeks before BMT and had flow cytometry analysis performed using a panel of monoclonal antibodies to myeloid antigens. The sensitivity of identifying a clonal cell population was approximately 0.1% of gated cells. For this analysis, the bone marrow results for the detection of MRD were grouped as being either negative (n = 11), < 1% (n = II), or 1% to 3% (n = 6). The RFS for pts without detectable MRD versus detectable MRD were 80% and 65%, respectively (p = .06). The RFS for patients with no MRD versus <1% MRD were 80% and 85%, respectively (p = >0.5). The RFS for patients with either no MRD and < 1% MRD versus > 1% MRD were 83% and 50%, respectively (p = .01); however, presence or absence of MRD did not influence overall survival: (53% versus 50%, respectively; p = 0.51). In summary, the detection of ?1% MRD was associated with a significantly lower RFS. There was no adverse outcome observed with patients who had < 1% MRD detected when compared to patients with no detectable MRD.

Original languageEnglish (US)
Pages (from-to)905
Number of pages1
JournalExperimental Hematology
Volume25
Issue number8
StatePublished - 1997
Externally publishedYes

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Residual Neoplasm
Bone Marrow Transplantation
Acute Myeloid Leukemia
Recurrence
Survival
Busulfan
Cyclophosphamide
Flow Cytometry
Bone Marrow
Cytarabine
Homologous Transplantation
Monoclonal Antibodies
Antigens
Population

ASJC Scopus subject areas

  • Cancer Research
  • Cell Biology
  • Genetics
  • Hematology
  • Oncology
  • Transplantation

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Presence of minimal residual disease (MRD) in acute myelogenous leukemia (AML) patients preallogeneic bone marrow transplantation (BMT) is associated with a lower relapse-free survival (RFS). / Holland, H. K.; Brav, R. A.; Otoole, K.; Holden, J. T.; Connaghan, P. O.; Heffiier, L. T.; Waller, E. K.; Winton, E. F.; Yeager, Andrew M.

In: Experimental Hematology, Vol. 25, No. 8, 1997, p. 905.

Research output: Contribution to journalArticle

Holland, H. K. ; Brav, R. A. ; Otoole, K. ; Holden, J. T. ; Connaghan, P. O. ; Heffiier, L. T. ; Waller, E. K. ; Winton, E. F. ; Yeager, Andrew M. / Presence of minimal residual disease (MRD) in acute myelogenous leukemia (AML) patients preallogeneic bone marrow transplantation (BMT) is associated with a lower relapse-free survival (RFS). In: Experimental Hematology. 1997 ; Vol. 25, No. 8. pp. 905.
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title = "Presence of minimal residual disease (MRD) in acute myelogenous leukemia (AML) patients preallogeneic bone marrow transplantation (BMT) is associated with a lower relapse-free survival (RFS)",
abstract = "We evaluated whether the presence of MRD detected by flow cytometry pre-BMT in patients (pts) with AML who were in complete remission (CR) by morphologic criteria was associated with an increased relapse rate after related allogeneic HLA-identical BMT Twenty-eight consecutive pts who had undergone allogeneic BMT with a median follow up of 31 months, (range, 10-64) were evaluated. The treatment regimen was either busulfan (Bu) and Cyclophosphamide (Cy) (n=2) or Bu, Cy and cytarabine (n=26). Twenty-one patients were in first CR (CRI) and 7 were in CR2. Disease status by FAB classification were 4 MO, 5 Ml, 7 M2, 3 M3, 6 M4, 1 M5, 1 M6 and I unclassified. Their median age was 46 yr (range, 20-62). All pts had bone marrow aspirates performed within 4 weeks before BMT and had flow cytometry analysis performed using a panel of monoclonal antibodies to myeloid antigens. The sensitivity of identifying a clonal cell population was approximately 0.1{\%} of gated cells. For this analysis, the bone marrow results for the detection of MRD were grouped as being either negative (n = 11), < 1{\%} (n = II), or 1{\%} to 3{\%} (n = 6). The RFS for pts without detectable MRD versus detectable MRD were 80{\%} and 65{\%}, respectively (p = .06). The RFS for patients with no MRD versus <1{\%} MRD were 80{\%} and 85{\%}, respectively (p = >0.5). The RFS for patients with either no MRD and < 1{\%} MRD versus > 1{\%} MRD were 83{\%} and 50{\%}, respectively (p = .01); however, presence or absence of MRD did not influence overall survival: (53{\%} versus 50{\%}, respectively; p = 0.51). In summary, the detection of ?1{\%} MRD was associated with a significantly lower RFS. There was no adverse outcome observed with patients who had < 1{\%} MRD detected when compared to patients with no detectable MRD.",
author = "Holland, {H. K.} and Brav, {R. A.} and K. Otoole and Holden, {J. T.} and Connaghan, {P. O.} and Heffiier, {L. T.} and Waller, {E. K.} and Winton, {E. F.} and Yeager, {Andrew M}",
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T1 - Presence of minimal residual disease (MRD) in acute myelogenous leukemia (AML) patients preallogeneic bone marrow transplantation (BMT) is associated with a lower relapse-free survival (RFS)

AU - Holland, H. K.

AU - Brav, R. A.

AU - Otoole, K.

AU - Holden, J. T.

AU - Connaghan, P. O.

AU - Heffiier, L. T.

AU - Waller, E. K.

AU - Winton, E. F.

AU - Yeager, Andrew M

PY - 1997

Y1 - 1997

N2 - We evaluated whether the presence of MRD detected by flow cytometry pre-BMT in patients (pts) with AML who were in complete remission (CR) by morphologic criteria was associated with an increased relapse rate after related allogeneic HLA-identical BMT Twenty-eight consecutive pts who had undergone allogeneic BMT with a median follow up of 31 months, (range, 10-64) were evaluated. The treatment regimen was either busulfan (Bu) and Cyclophosphamide (Cy) (n=2) or Bu, Cy and cytarabine (n=26). Twenty-one patients were in first CR (CRI) and 7 were in CR2. Disease status by FAB classification were 4 MO, 5 Ml, 7 M2, 3 M3, 6 M4, 1 M5, 1 M6 and I unclassified. Their median age was 46 yr (range, 20-62). All pts had bone marrow aspirates performed within 4 weeks before BMT and had flow cytometry analysis performed using a panel of monoclonal antibodies to myeloid antigens. The sensitivity of identifying a clonal cell population was approximately 0.1% of gated cells. For this analysis, the bone marrow results for the detection of MRD were grouped as being either negative (n = 11), < 1% (n = II), or 1% to 3% (n = 6). The RFS for pts without detectable MRD versus detectable MRD were 80% and 65%, respectively (p = .06). The RFS for patients with no MRD versus <1% MRD were 80% and 85%, respectively (p = >0.5). The RFS for patients with either no MRD and < 1% MRD versus > 1% MRD were 83% and 50%, respectively (p = .01); however, presence or absence of MRD did not influence overall survival: (53% versus 50%, respectively; p = 0.51). In summary, the detection of ?1% MRD was associated with a significantly lower RFS. There was no adverse outcome observed with patients who had < 1% MRD detected when compared to patients with no detectable MRD.

AB - We evaluated whether the presence of MRD detected by flow cytometry pre-BMT in patients (pts) with AML who were in complete remission (CR) by morphologic criteria was associated with an increased relapse rate after related allogeneic HLA-identical BMT Twenty-eight consecutive pts who had undergone allogeneic BMT with a median follow up of 31 months, (range, 10-64) were evaluated. The treatment regimen was either busulfan (Bu) and Cyclophosphamide (Cy) (n=2) or Bu, Cy and cytarabine (n=26). Twenty-one patients were in first CR (CRI) and 7 were in CR2. Disease status by FAB classification were 4 MO, 5 Ml, 7 M2, 3 M3, 6 M4, 1 M5, 1 M6 and I unclassified. Their median age was 46 yr (range, 20-62). All pts had bone marrow aspirates performed within 4 weeks before BMT and had flow cytometry analysis performed using a panel of monoclonal antibodies to myeloid antigens. The sensitivity of identifying a clonal cell population was approximately 0.1% of gated cells. For this analysis, the bone marrow results for the detection of MRD were grouped as being either negative (n = 11), < 1% (n = II), or 1% to 3% (n = 6). The RFS for pts without detectable MRD versus detectable MRD were 80% and 65%, respectively (p = .06). The RFS for patients with no MRD versus <1% MRD were 80% and 85%, respectively (p = >0.5). The RFS for patients with either no MRD and < 1% MRD versus > 1% MRD were 83% and 50%, respectively (p = .01); however, presence or absence of MRD did not influence overall survival: (53% versus 50%, respectively; p = 0.51). In summary, the detection of ?1% MRD was associated with a significantly lower RFS. There was no adverse outcome observed with patients who had < 1% MRD detected when compared to patients with no detectable MRD.

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