Clinical Research Division, Fred Hutchinson Cancer Research Center, USA; Division of Medical Oncology, University of Washington, School of Medicine, 1100 Fairview Avenue North, D5-310, PO Box 19024, Seattle, WA 98109-1024, USA.
Best Pract Res Clin Haematol. 2013 Sep;26(3):279-84. doi: 10.1016/j.beha.2013.10.008. Epub 2013 Oct 16.
Multiparameter flow cytometry (MFC) can identify leukemia-associated immunophenotypes in more than 90% of cases of acute leukemia with detection limits of 10(-3)-10(-4). In order to better understand the potential utility of MFC to measure minimal residual disease (MRD) in the setting of myeloablative hematopoietic cell transplantation (HCT), we studied cohorts of patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) in complete remission (CR) both pre- and post-HCT. Among 253 patients with AML, the 3-year estimates of overall survival were 73% (CR1) and 73% (CR2) for those who were MRD(neg) and 32% (CR1) and 44% (CR2) for those who were MRD(pos), with relapse rates being more than doubled in those who were MRD(pos) pre-HCT (21% vs 58% for CR1 patients and 19% vs 68% for CR2 patients). The presence of MRD anytime during the first 100 days post-HCT predicted a 6-fold higher risk of subsequent relapse. In 157 patients with ALL, the 3-year overall survivals were 68% for the MRD(neg) cohort vs 40% for those who were MRD(pos) pre-HCT, with probabilities of relapse of 16% in those who were MRD(neg) vs 33% in the MRD(pos) group. As in AML, the presence of MRD in the post-transplant setting indicated that the risk of subsequent relapse was high, but not inevitable.
多参数流式细胞术（MFC）可以在超过 90%的急性白血病病例中识别出与白血病相关的免疫表型，检测限为 10(-3)-10(-4)。为了更好地了解 MFC 在清髓性造血细胞移植（HCT）背景下测量微小残留病（MRD）的潜在效用，我们研究了处于缓解期（CR）的急性髓细胞白血病（AML）和急性淋巴细胞白血病（ALL）患者的队列，包括移植前和移植后。在 253 例 AML 患者中，MRD（neg）的患者 3 年总生存率为 73%（CR1）和 73%（CR2），而 MRD（pos）的患者为 32%（CR1）和 44%（CR2），MRD（pos）的患者复发率高于 MRD（neg）的患者（CR1 患者为 21%比 58%，CR2 患者为 19%比 68%）。移植后 100 天内任何时候存在 MRD 都预示着随后复发的风险增加 6 倍。在 157 例 ALL 患者中，MRD（neg）组的 3 年总生存率为 68%，而移植前 MRD（pos）的患者为 40%，MRD（neg）组的复发率为 16%，而 MRD（pos）组的复发率为 33%。与 AML 一样，移植后存在 MRD 表明复发风险高，但并非不可避免。
