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, A. 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)
Number of pages1
JournalExperimental Hematology
Volume25
Issue number8
StatePublished - 1997

ASJC Scopus subject areas

  • Molecular Biology
  • Hematology
  • Genetics
  • Cell Biology
  • Cancer Research

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