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 Blood, 15 December 2007, Vol. 110, No. 13, pp. 4172-4174.
Prepublished online as a Blood First Edition Paper on October 1, 2007; DOI 10.1182/blood-2007-07-104091.

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CLINICAL TRIALS AND OBSERVATIONS

Brief Report

Early peripheral blood blast clearance during induction chemotherapy for acute myeloid leukemia predicts superior relapse-free survival

Michelle A. Elliott1, Mark R. Litzow1, Louis L. Letendre1, Robert C. Wolf2, Curtis A. Hanson3, Ayalew Tefferi1, and Martin S. Tallman4

1 Division of Hematology, Department of Internal Medicine, 2 Pharmacy Services, and 3 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; and 4 Northwestern University, Chicago, IL

In childhood acute lymphoblastic leukemia (ALL), a rapid decline of circulating leukemic blasts in response to induction chemotherapy or prednisone is one of the most important prognostic factors, not only for achieving remission but also for relapse-free survival (RFS). However, in acute myeloid leukemia (AML) parameters of chemosensitivity have been restricted mainly to the rapidity of achievement of complete remission (CR) or the assessment of residual leukemic bone marrow blasts during aplasia. We hypothesized that the time to circulating peripheral blood blast clearance, as a potential surrogate for in vivo chemosensitivity, would have prognostic relevance in AML also. In a retrospective analysis of a cohort of 86 adult patients with AML receiving uniform induction and consolidation chemotherapy, we demonstrate that the time to clearance of circulating blasts during induction chemotherapy is an independent prognostic marker of RFS, superseding other known or established risk factors, including karyotype and number of inductions to achieve CR.


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Related Article in Blood Online:

Peripheral blood blast clearance during induction therapy in acute myeloid leukemia
Giacomo Gianfaldoni, Francesco Mannelli, Sara Bencini, Franco Leoni, Simone Baldini, and Alberto Bosi
Blood 2008 111: 1746-1747. [Full Text] [PDF]



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G. Gianfaldoni, F. Mannelli, S. Bencini, F. Leoni, S. Baldini, and A. Bosi
Peripheral blood blast clearance during induction therapy in acute myeloid leukemia
Blood, February 1, 2008; 111(3): 1746 - 1747.
[Full Text] [PDF]


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