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Residual disease detected by flow cytometry is an independent predictor of survival in childhood acute myeloid leukaemia; results of the NOPHO-AML 2004 study
Toronto Gen Hosp, Univ Hlth Network, Dept Pathobiol & Lab Med, 200 Elizabeth St,11th Floor, Toronto, ON M5G 2C4, Canada.;Oslo Univ Hosp, Dept Pathol, Oslo, Norway..
Karolinska Univ Hosp, Dept Pathol, Stockholm, Sweden..
Helsinki Univ Cent Hosp, Lab Serv, Hosp Dist Helsinki, Helsinki, Finland.;Helsinki Univ Cent Hosp, Uusimaa Lab, Helsinki, Finland..
Rigshosp, Dept Clin Immunol, Sect 7631, Copenhagen Univ Hosp, Copenhagen, Denmark..
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2016 (English)In: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 174, no 4, 600-609 p.Article in journal (Refereed) Published
Abstract [en]

Early response after induction is a prognostic factor for disease outcome in childhood acute myeloid leukaemia (AML). Residual disease (RD) detection by multiparameter flow cytometry (MFC) was performed at day 15 and before consolidation therapy in 101 patients enrolled in the Nordic Society of Paediatric Haemato-Oncology AML 2004 study. A multicentre laboratory approach to RD analysis was used. Event-free survival (EFS) and overall survival (OS) was significantly different in patients with and without RD at both time points, using a 0.1% RD cut-off level. RD-negative and -positive patients after first induction showed a 5-year EFS of 65.7% and 22.7%, respectively (P < 0.001) and an OS of 77.6% (P = 0.025) and 51.8%. RD-negative and -positive patients at start of consolidation therapy had a 5-year EFS of 57.7% and 11.7%, respectively (P < 0001) and an OS of 786% and 2811%) (P < 0001). In multivariate analysis only RD was significantly correlated with survival. RD before consolidation therapy was the strongest independent prognostic factor for EFS [hazard ratio (HR): 5.0; 95% confidence interval (CI): 1.9-133] and OS (HR: 7.0; 95% CI: 20-245). In conclusion, RD before consolidation therapy identifies patients at high risk of relapse in need of intensified treatment. In addition, RD detection can be performed in a multicentre setting and can be implemented in future trials.

Place, publisher, year, edition, pages
2016. Vol. 174, no 4, 600-609 p.
Keyword [en]
acute myeloid leukaemia, flow cytometry, minimal residual disease, prognosis, survival
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-305575DOI: 10.1111/bjh.14093ISI: 000383774500014PubMedID: 27072379OAI: oai:DiVA.org:uu-305575DiVA: diva2:1038560
Available from: 2016-10-19 Created: 2016-10-19 Last updated: 2016-10-19Bibliographically approved

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