流式细胞术检测的移植前微小残留病水平在急性髓系白血病异基因干细胞移植受者中的作用
Role of pre-transplant MRD level detected by flow cytometry in recipients of allogeneic stem cell transplantation with AML.
作者信息
Klyuchnikov Evgeny, Christopeit Maximilian, Badbaran Anita, Bacher Ulrike, Fritzsche-Friedland Ulrike, von Pein Ute-Marie, Wolschke Christine, Kröger Nicolaus
机构信息
Department of Stem Cell Transplantation, University Medical Center Eppendorf, University of Hamburg, Hamburg, Germany.
Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, Bern, Switzerland.
出版信息
Eur J Haematol. 2021 May;106(5):606-615. doi: 10.1111/ejh.13557. Epub 2021 Feb 15.
OBJECTIVES AND METHODS
We analyzed the impact of pretransplant MRD level in bone marrow measured by flow cytometry using "different from normal" method on outcomes for 189 AML patients (108 males; median age, 58 (21-80) years). All patients were subdivided into negative (n = 96), "low" (0.1%-0.5%, n = 32), and "high" MRD (>0.5%, n = 61) groups.
RESULTS
In multivariate analysis, the hazard ratios for "high" and "low" MRD levels related to MRD negativity were 7.9 (95% CI 3.5-18.1, P < .001) and 5.4 (95% CI 2.1-14, P = .0058) for relapse; 2.3 (95% CI 1.3-4.1, P = .006) and 1.6 (95% CI 0.82-3.3, P = .16) for OS; and 2.8 (95% CI 1.7-4.7, P < .001) and 2.2 (95% CI 1.1-4.2, P = .02) for LFS, respectively. We found no significant impact of "low" MRD level on relapses (0.68, 95% CI 0.33-1.4, P = .30), OS (0.72, 95% CI: 0.36-1.5, P = .36) and LFS (0.79, 95% CI: 0.42-1.5, P = .46) related to "high" MRD group.
CONCLUSIONS
Presence of detectable MRD was indicative for a high relapse risk, low LFS and OS. "Low" MRD level showed no significant impact on relapse, LFS and OS related to "high" MRD group.
目的与方法
我们采用“不同于正常”的方法，通过流式细胞术分析了189例急性髓系白血病（AML）患者（108例男性；中位年龄58（21 - 80）岁）移植前骨髓中微小残留病（MRD）水平对预后的影响。所有患者被分为阴性组（n = 96）、“低”MRD组（0.1% - 0.5%，n = 32）和“高”MRD组（>0.5%，n = 61）。
结果
在多变量分析中，与MRD阴性相比，“高”和“低”MRD水平的复发风险比分别为7.9（95%可信区间3.5 - 18.1，P <.001）和5.4（95%可信区间2.1 - 14，P =.0058）；总生存期（OS）风险比分别为2.3（95%可信区间1.3 - 4.1，P =.006）和1.6（95%可信区间0.82 - 3.3，P =.16）；无病生存期（LFS）风险比分别为2.8（95%可信区间1.7 - 4.7，P <.001）和2.2（95%可信区间1.1 - 4.2，P =.02）。我们发现“低”MRD水平与“高”MRD组相比，对复发（0.68，95%可信区间0.33 - 1.4，P =.30）、OS（0.72，95%可信区间：0.
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