Postremission sequential monitoring of minimal residual disease by WT1 Q-PCR and multiparametric flow cytometry assessment predicts relapse and may help to address risk-adapted therapy in acute myeloid leukemia patients

作者：Malagola Michele; Skert Cristina; Borlenghi Erika; Chiarini Marco; Cattaneo Chiara; Morello Enrico; Cancelli Valeria; Cattina Federica; Cerqui Elisa; Pagani Chiara; Passi Angela; Ribolla Rossella; Bernardi Simona; Giustini Viviana; Lamorgese Cinzia; Ruggeri Giuseppina; Imberti Luisa; Caimi Luigi; Russo Domenico; Rossi Giuseppe

来源：Cancer Medicine, 2016, 5(2): 265-274.

DOI：10.1002/cam4.593

• LAIP
• minimal residual disease
• WT1

Risk stratification in acute myeloid leukemia (AML) patients using prognostic parameters at diagnosis is effective, but may be significantly improved by the use of on treatment parameters which better define the actual sensitivity to therapy in the single patient. Minimal residual disease (MRD) monitoring has been demonstrated crucial for the identification of AML patients at high risk of relapse, but the best method and timing of MRD detection are still discussed. Thus, we retrospectively analyzed 104 newly diagnosed AML patients, consecutively treated and monitored by quantitative polymerase chain reactions (Q-PCR) on WT1 and by multiparametric flow cytometry (MFC) on leukemia-associated immunophenotypes (LAIPs) at baseline, after induction, after 1st consolidation and after 1st intensification. By multivariate analysis, the factors independently associated with adverse relapse-free survival (RFS) were: bone marrow (BM)-WT1121/10(4) ABL copies (P=0.02) and LAIP0.2% (P=0.0001) (after 1st consolidation) (RFS at the median follow up of 12.5months: 51% vs. 82% [P<0.0001] and 57% vs. 81%, respectively [P=0.0003]) and PB-WT116/10(4) ABL copies (P=0.0001) (after 1st intensification) (RFS 43% vs. 95% [P<0.0001]) Our data confirm the benefits of sequential MRD monitoring with both Q-PCR and MFC. If confirmed by further prospective trials, they may significantly improve the possibility of a risk-adapted, postinduction therapy of AML.

• 出版日期2016-2