行造血细胞移植的急性髓系白血病患者中细胞遗传学和流式细胞术结果不一致的预后影响。
Prognostic impact of discordant results from cytogenetics and flow cytometry in patients with acute myeloid leukemia undergoing hematopoietic cell transplantation.
机构信息
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1023, USA.
出版信息
Cancer. 2012 May 1;118(9):2411-9. doi: 10.1002/cncr.26539. Epub 2011 Sep 16.
Abstract
BACKGROUND
Cytogenetics and multicolor flow cytometry (MFC) are useful tools for monitoring outcome of treatment in acute myeloid leukemia (AML). However, no data are available regarding the meaning of results when the 2 tests do not agree.
METHODS
The authors of this report analyzed 1464 pairs of concurrent cytogenetics and flow results from 424 patients, before and after hematopoietic cell transplantation, and compared the prognostic impact of discordant and concordant results.
RESULTS
Informative discordant results were observed in 22% of patients. Compared with patients who had double-negative test results, either positive result had a significant impact on overall survival and relapse-free survival. The hazard ratios with either positive cytogenetic results or positive MFC results pretransplantation were 3.1 (P = .009) and 2.5 (P = .0008), respectively, for reduced overall survival and 2.7 (P = .01) and 4.1 (P < .0001), respectively, for decreased recurrence-free survival. Similar findings were obtained post-transplantation. Molecular cytogenetics, ie, fluorescence in situ hybridization (FISH), added value to the evaluation of discordant cases.
CONCLUSIONS
The detection of residual AML by either cytogenetics or flow cytometry in patients who underwent hematopoietic cell transplantation predicted early relapse and shortened survival.
摘要
背景
细胞遗传学和多色流式细胞术（MFC）是监测急性髓系白血病（AML）治疗结果的有用工具。然而，当这两种检测方法不一致时，关于结果意义的数据尚不清楚。
方法
本报告的作者分析了 424 例患者造血细胞移植前后 1464 对同时进行的细胞遗传学和流式结果，并比较了不一致和一致结果的预后影响。
结果
在 22%的患者中观察到有意义的不一致结果。与双阴性检测结果的患者相比，任一阳性结果均对总生存和无复发生存有显著影响。移植前阳性细胞遗传学结果或阳性 MFC 结果的风险比分别为 3.1（P =.009）和 2.5（P =.0008），总生存率降低；分别为 2.7（P =.01）和 4.1（P <.0001），无复发生存率降低。移植后也得到了类似的发现。分子细胞遗传学，即荧光原位杂交（FISH），增加了对不一致病例的评估价值。
结论
接受造血细胞移植的患者通过细胞遗传学或流式细胞术检测到残留的 AML 可预测早期复发并缩短生存期。
相似文献
1
Prognostic impact of discordant results from cytogenetics and flow cytometry in patients with acute myeloid leukemia undergoing hematopoietic cell transplantation.行造血细胞移植的急性髓系白血病患者中细胞遗传学和流式细胞术结果不一致的预后影响。
Cancer. 2012 May 1;118(9):2411-9. doi: 10.1002/cncr.26539. Epub 2011 Sep 16.
2
Impact of pretransplantation minimal residual disease, as detected by multiparametric flow cytometry, on outcome of myeloablative hematopoietic cell transplantation for acute myeloid leukemia.多参数流式细胞术检测移植前微小残留病对急性髓系白血病清髓性造血细胞移植结局的影响。
J Clin Oncol. 2011 Mar 20;29(9):1190-7. doi: 10.1200/JCO.2010.31.8121. Epub 2011 Jan 31.
3
Minimal residual disease by either flow cytometry or cytogenetics prior to an allogeneic hematopoietic stem cell transplant is associated with poor outcome in acute myeloid leukemia.在异基因造血干细胞移植前，通过流式细胞术或细胞遗传学检测到的微小残留病与急性髓系白血病的不良预后相关。
Blood Cancer J. 2017 Nov 27;7(12):634. doi: 10.1038/s41408-017-0007-x.
4
The applicability of multiparameter flow cytometry for the detection of minimal residual disease using different-from-normal panels to predict relapse in patients with acute myeloid leukemia after allogeneic transplantation.多参数流式细胞术使用不同于正常的面板检测微小残留病在异基因移植后急性髓系白血病患者中的应用，以预测复发。
Int J Lab Hematol. 2019 Oct;41(5):607-614. doi: 10.1111/ijlh.13070. Epub 2019 Jun 4.
5
Prognostic impact of minimal residual disease analysis by flow cytometry in patients with acute myeloid leukemia before and after allogeneic hemopoietic stem cell transplantation.流式细胞术检测微小残留病对急性髓系白血病患者异基因造血干细胞移植前后的预后影响
Eur J Haematol. 2014 Sep;93(3):239-46. doi: 10.1111/ejh.12336. Epub 2014 Apr 29.
6
Pre-transplantation minimal residual disease with cytogenetic and molecular diagnostic features improves risk stratification in acute myeloid leukemia.具有细胞遗传学和分子诊断特征的移植前微小残留病可改善急性髓系白血病的风险分层。
Haematologica. 2017 Jan;102(1):110-117. doi: 10.3324/haematol.2016.144253. Epub 2016 Aug 18.
7
Minimal residual disease detected by multiparameter flow cytometry is complementary to genetics for risk stratification treatment in acute myeloid leukemia with biallelic CEBPA mutations.多参数流式细胞术检测到的微小残留病可补充双等位基因 CEBPA 突变的急性髓细胞白血病的遗传学风险分层治疗。
Leuk Lymphoma. 2019 Sep;60(9):2181-2189. doi: 10.1080/10428194.2019.1576868. Epub 2019 Feb 18.
8
Multigene Measurable Residual Disease Assessment Improves Acute Myeloid Leukemia Relapse Risk Stratification in Autologous Hematopoietic Cell Transplantation.多基因可测量残留病评估改善自体造血细胞移植中急性髓系白血病的复发风险分层
Biol Blood Marrow Transplant. 2016 Nov;22(11):1974-1982. doi: 10.1016/j.bbmt.2016.08.014. Epub 2016 Aug 17.
9
Minimal Identifiable Disease and the Role of Conditioning Intensity in Hematopoietic Cell Transplantation for Myelodysplastic Syndrome and Acute Myelogenous Leukemia Evolving from Myelodysplastic Syndrome.微小可识别疾病以及预处理强度在骨髓增生异常综合征及由骨髓增生异常综合征演变而来的急性髓系白血病造血细胞移植中的作用
Biol Blood Marrow Transplant. 2016 Jul;22(7):1227-1233. doi: 10.1016/j.bbmt.2016.03.029. Epub 2016 Apr 6.
10
Monosomal karyotype as an adverse prognostic factor in patients with acute myeloid leukemia treated with allogeneic hematopoietic stem-cell transplantation in first complete remission: a retrospective survey on behalf of the ALWP of the EBMT.单倍体核型作为首次完全缓解期接受异基因造血干细胞移植治疗的急性髓系白血病患者的不良预后因素：代表欧洲血液与骨髓移植协会急性白血病工作组进行的一项回顾性调查
Haematologica. 2016 Feb;101(2):248-55. doi: 10.3324/haematol.2015.132654. Epub 2015 Nov 20.
引用本文的文献
1
Measurable (Minimal) Residual Disease in Myelodysplastic Neoplasms (MDS): Current State and Perspectives.骨髓增生异常综合征（MDS）中的可测量（微小）残留病：现状与展望
Cancers (Basel). 2024 Apr 15;16(8):1503. doi: 10.3390/cancers16081503.
2
Relative prognostic value of flow cytometric measurable residual disease before allogeneic hematopoietic cell transplantation for adults with MDS/AML or AML.流式细胞术检测 MDS/AML 或 AML 成人患者异基因造血细胞移植前微小残留病的相对预后价值。
Am J Hematol. 2024 May;99(5):862-870. doi: 10.1002/ajh.27259. Epub 2024 Feb 21.
3
Relative impact of residual cytogenetic abnormalities and flow cytometric measurable residual disease on outcome after allogeneic hematopoietic cell transplantation in adult acute myeloid leukemia.成人急性髓系白血病异基因造血细胞移植后残留细胞遗传学异常和流式细胞术可测量残留病对结局的相对影响。
Haematologica. 2023 Feb 1;108(2):420-432. doi: 10.3324/haematol.2022.281585.
4
Targeting an alternate Wilms' tumor antigen 1 peptide bypasses immunoproteasome dependency.靶向替代 Wilms' 肿瘤抗原 1 肽可绕过免疫蛋白酶体依赖性。
Sci Transl Med. 2022 Feb 9;14(631):eabg8070. doi: 10.1126/scitranslmed.abg8070.
5
MRD Tailored Therapy in AML: What We Have Learned So Far.急性髓系白血病中微小残留病定制疗法：我们目前所了解的情况。
Front Oncol. 2021 Jan 15;10:603636. doi: 10.3389/fonc.2020.603636. eCollection 2020.
6
T cell receptor gene therapy targeting WT1 prevents acute myeloid leukemia relapse post-transplant.靶向 WT1 的 T 细胞受体基因治疗可预防移植后急性髓系白血病复发。
Nat Med. 2019 Jul;25(7):1064-1072. doi: 10.1038/s41591-019-0472-9. Epub 2019 Jun 24.
7
Clonal Heterogeneity Reflected by PI3K-AKT-mTOR Signaling in Human Acute Myeloid Leukemia Cells and Its Association with Adverse Prognosis.PI3K-AKT-mTOR信号传导在人类急性髓系白血病细胞中反映的克隆异质性及其与不良预后的关联。
Cancers (Basel). 2018 Sep 14;10(9):332. doi: 10.3390/cancers10090332.
8
Impact of copy neutral loss of heterozygosity and total genome aberrations on survival in myelodysplastic syndrome.杂合性缺失和全基因组畸变对骨髓增生异常综合征生存的影响。
Mod Pathol. 2018 Apr;31(4):569-580. doi: 10.1038/modpathol.2017.157. Epub 2017 Dec 15.
9
Recommendations for reporting post-transplant relapse in AML.急性髓系白血病移植后复发报告的建议。
Bone Marrow Transplant. 2018 Feb;53(2):111-113. doi: 10.1038/bmt.2017.227. Epub 2017 Oct 30.
10
Minimal Identifiable Disease and the Role of Conditioning Intensity in Hematopoietic Cell Transplantation for Myelodysplastic Syndrome and Acute Myelogenous Leukemia Evolving from Myelodysplastic Syndrome.微小可识别疾病以及预处理强度在骨髓增生异常综合征及由骨髓增生异常综合征演变而来的急性髓系白血病造血细胞移植中的作用
Biol Blood Marrow Transplant. 2016 Jul;22(7):1227-1233. doi: 10.1016/j.bbmt.2016.03.029. Epub 2016 Apr 6.
本文引用的文献
1
Impact of pretransplantation minimal residual disease, as detected by multiparametric flow cytometry, on outcome of myeloablative hematopoietic cell transplantation for acute myeloid leukemia.多参数流式细胞术检测移植前微小残留病对急性髓系白血病清髓性造血细胞移植结局的影响。
J Clin Oncol. 2011 Mar 20;29(9):1190-7. doi: 10.1200/JCO.2010.31.8121. Epub 2011 Jan 31.
2
Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet.成人急性髓系白血病的诊断和治疗：代表欧洲白血病网的国际专家小组的建议。
Blood. 2010 Jan 21;115(3):453-74. doi: 10.1182/blood-2009-07-235358. Epub 2009 Oct 30.
3
Ten-color immunophenotyping of hematopoietic cells.造血细胞的十色免疫表型分析。
Curr Protoc Cytom. 2005 Aug;Chapter 6:Unit6.21. doi: 10.1002/0471142956.cy0621s33.
4
Toward optimization of postremission therapy for residual disease-positive patients with acute myeloid leukemia.针对急性髓系白血病残留病阳性患者缓解后治疗的优化
J Clin Oncol. 2008 Oct 20;26(30):4944-51. doi: 10.1200/JCO.2007.15.9814. Epub 2008 Jul 7.
5
Myeloid malignancies: myelodysplastic syndromes, myeloproliferative disorders, and acute myeloid leukemia.髓系恶性肿瘤：骨髓增生异常综合征、骨髓增殖性疾病和急性髓系白血病。
Clin Lab Med. 2007 Sep;27(3):551-75, vii. doi: 10.1016/j.cll.2007.05.006.
6
9-color and 10-color flow cytometry in the clinical laboratory.临床实验室中的九色和十色流式细胞术。
Arch Pathol Lab Med. 2006 May;130(5):680-90. doi: 10.5858/2006-130-680-CACFCI.
7
Evaluation of complete disease remission in acute myeloid leukemia: a prospective study based on cytomorphology, interphase fluorescence in situ hybridization, and immunophenotyping during follow-up in patients with acute myeloid leukemia.急性髓系白血病完全疾病缓解的评估：一项基于细胞形态学、间期荧光原位杂交及免疫表型分析的前瞻性研究，该研究对急性髓系白血病患者随访期间进行。
Cancer. 2006 Feb 15;106(4):839-47. doi: 10.1002/cncr.21665.
8
Abnormal cytogenetics at date of morphologic complete remission predicts short overall and disease-free survival, and higher relapse rate in adult acute myeloid leukemia: results from cancer and leukemia group B study 8461.形态学完全缓解时的异常细胞遗传学可预测成人急性髓系白血病的总生存期和无病生存期较短，以及复发率较高：癌症与白血病B组研究8461的结果
J Clin Oncol. 2004 Jun 15;22(12):2410-8. doi: 10.1200/JCO.2004.03.023.
9
10
Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461).预处理细胞遗传学异常可预测初发急性髓系白血病成年患者的诱导缓解成功率、累积复发率及总生存期：癌症与白血病B组研究结果（CALGB 8461）
Blood. 2002 Dec 15;100(13):4325-36. doi: 10.1182/blood-2002-03-0772. Epub 2002 Aug 1.
Zotero 插件