Peng N, Wei H, Lin D, Zhou C L, Liu B C, Wang Y, Liu K Q, Gong B F, Wei S N, Zhang G J, Liu Y T, Gong X Y, Qiu S W, Mi Y C, Wang J X
Institute of Hematology & Blood Disease Hospital, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2017 Sep 14;38(9):767-771. doi: 10.3760/cma.j.issn.0253-2727.2017.09.007.
To investigate the impact of minimal residual disease (MRD) by multiparameter flow cytometry (MPFC) during aplasia on efficacy and prognosis of de novo acute myeloid leukemia (AML) (non M(3)) patients. The MRD data by 8-color MPFC during aplasia (day 14-15 of induction therapy) in 85 de novo AML (non M(3)) patients and the MRD impact on efficacy and prognosis were retrospectively analyzed. Data of 85 patients, including 42 males (49.4%) and 43 females (50.6%) , were collected, with a median age of 35 (15-54) years. The median MRD by MPFC during aplasia was 0.58% (0-81.11%) , and 70 (82.4%) patients achieved complete remission (CR) after first induction chemotherapy. The cutoff of MRD by receiver operating characteristic (ROC) analysis was 2.305% (Se= 0.867, Sp=0.800) . The CR rate after one course was significantly higher in patients with MRD<2.305% [96.6% (56/58) ]than in patients with MRD≥2.305%[51.9% (14/27) ] ((2)=22.348, <0.001) ; no significant difference with respect to relapse-free survival rate ((2)=1.08, =0.299) or overall survival rate ((2)=0.42, =0.516) could be demonstrated for the comparison of the two groups. Multivariates analysis showed MRD divided by 2.305% was the only independent prognostic factor for CR after one course (= 21.560, 95% 4.129-112.579, <0.001) . Flow cytometric MRD divided by 2.305% during aplasia could be a predictor of efficacy after first induction therapy in AML patients.
为研究再生障碍期多参数流式细胞术（MPFC）检测微小残留病（MRD）对初治急性髓系白血病（AML）（非M3型）患者疗效及预后的影响。回顾性分析85例初治AML（非M3型）患者在再生障碍期（诱导治疗第14 - 15天）通过8色MPFC检测的MRD数据及其对疗效和预后的影响。收集了85例患者的数据，其中男性42例（49.4%），女性43例（50.6%），中位年龄35（15 - 54）岁。再生障碍期MPFC检测的MRD中位数为0.58%（0 - 81.11%），70例（82.4%）患者首次诱导化疗后达到完全缓解（CR）。通过受试者工作特征（ROC）分析确定MRD的截断值为2.305%（敏感性= 0.867，特异性=0.800）。MRD<2.305%的患者一个疗程后的CR率[96.6%（56/58）]显著高于MRD≥2.305%的患者[51.9%（14/27）]（χ²=22.348，P<0.001）；两组在无复发生存率（χ²=1.08，P=0.299）或总生存率（χ²=0.42，P=0.516）方面比较无显著差异。多因素分析显示，以2.305%为界划分的MRD是一个疗程后CR的唯一独立预后因素（χ²= 21.560，95%置信区间4.129 - 112.579，P<0.001）。再生障碍期流式细胞术检测的MRD以2.305%为界可作为AML患者首次诱导治疗后疗效的预测指标。
