MRD-directed risk stratification treatment may improve outcomes of t(8;21) AML in the first complete remission: results from the AML05 multicenter trial
2013; Elsevier BV; Volume: 121; Issue: 20 Linguagem: Inglês
10.1182/blood-2012-11-468348
ISSN1528-0020
AutoresHong‐Hu Zhu, Xiaohui Zhang, Ya‐Zhen Qin, Dai‐Hong Liu, Hao Jiang, Huan Chen, Qian Jiang, Lan‐Ping Xu, Jin Lu, Wei Han, Li Bao, Yu Wang, Yu‐Hong Chen, Jingzhi Wang, Feng‐Rong Wang, Yue‐Yun Lai, Jun-Yue Chai, Liru Wang, Yanrong Liu, Kai‐Yan Liu, Bin Jiang, Xiao‐Jun Huang,
Tópico(s)CNS Lymphoma Diagnosis and Treatment
ResumoWe aimed to improve the outcome of t(8;21) acute myeloid leukemia (AML) in the first complete remission (CR1) by applying risk-directed therapy based on minimal residual disease (MRD) determined by RUNX1/RUNX1T1 transcript levels. Risk-directed therapy included recommending allogeneic hematopoietic stem cell transplantation (allo-HSCT) for high-risk patients and chemotherapy/autologous-HSCT (auto-HSCT) for low-risk patients. Among 116 eligible patients, MRD status after the second consolidation rather than induction or first consolidation could discriminate high-risk relapse patients (P = .001). Allo-HSCT could reduce relapse and improve survival compared with chemotherapy for high-risk patients (cumulative incidence of relapse [CIR]: 22.1% vs 78.9%, P < .0001; disease-free survival [DFS]: 61.7% vs 19.6%, P = .001), whereas chemotherapy/auto-HSCT achieved a low relapse rate (5.3%) and high DFS (94.7%) for low-risk patients. Multivariate analysis revealed that MRD status and treatment choice were independent prognostic factors for relapse, DFS, and OS. We concluded that MRD status after the second consolidation may be the best timing for treatment choice. MRD-directed risk stratification treatment may improve the outcome of t(8;21) AML in CR1. This trial was registered at http://www.chictr.org as #ChiCTR-OCH-12002406.
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