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Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 September 2001, Vol. 98, No. 6, pp. 1746-1751 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Early immunophenotypical evaluation of minimal residual disease in acute myeloid leukemia identifies different patient risk groups and may contribute to postinduction treatment stratification Jesús F. San Miguel, María B. Vidriales, Consuelo López-Berges, Joaquín Díaz-Mediavilla, Norma Gutiérrez, Consuelo Cañizo, Fernando Ramos, María J. Calmuntia, José J. Pérez, Marcos González, and Alberto Orfao From the Department of Hematology, University Hospital; Department of Cytometry, University of Salamanca; Centro de Investigación del Cancer, Salamanca; Department of Hematology, San Carlos University Hospital, Madrid; Department of Hematology, Complejo Hospitalario, León; and Department of Hematology, General Hospital, Segovia, Spain. Early response to therapy is one of the most important prognostic factors in acute leukemia. It is hypothesized that early immunophenotypical evaluation may help identify patients at high risk for relapse from those who may remain in complete remission (CR). Using multiparametric flow cytometry, the level of minimal residual disease (MRD) was evaluated in the first bone marrow (BM) in morphologic CR obtained after induction treatment from 126 patients with acute myeloid leukemia (AML) who displayed aberrant phenotypes at diagnosis. Based on MRD level, 4 different risk categories were identified: 8 patients were at very low risk (fewer than 104 cells), and none have relapsed thus far; 37 were at low risk (104 to 103 cells); and 64 were at intermediate risk (fewer than 103 to 102 cells), with 3-year cumulative relapse rates of 14% and 50%, respectively. The remaining 17 patients were in the high-risk group (more than 102 residual aberrant cells) and had a 3-year relapse rate of 84% (P = .0001). MRD level not only influences relapse-free survival but also overall survival (P = .003). The adverse prognostic impact was also observed when M3 and non-M3 patients with AML were separately analyzed, and was associated with adverse cytogenetic subtypes, 2 or more cycles to achieve CR, and high white blood cell counts. Multivariate analysis showed that MRD level was the most powerful independent prognostic factor, followed by cytogenetics and number of cycles to achieve CR. In conclusion, immunophenotypical investigation of MRD in the first BM in mCR obtained after AML induction therapy provides important information for risk assessment in patients with AML. © 2001 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. Mateo, M. A. Montalban, M.-B. Vidriales, J. J. Lahuerta, M. V. Mateos, N. Gutierrez, L. Rosinol, L. Montejano, J. Blade, R. Martinez, et al. Prognostic Value of Immunophenotyping in Multiple Myeloma: A Study by the PETHEMA/GEM Cooperative Study Groups on Patients Uniformly Treated With High-Dose Therapy J. Clin. Oncol., June 1, 2008; 26(16): 2737 - 2744. [Abstract] [Full Text] [PDF] A. C. Rawstron, A. Orfao, M. Beksac, L. Bezdickova, R. A. Brooimans, H. Bumbea, K. Dalva, G. Fuhler, J. Gratama, D. Hose, et al. 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	Copyright © 2001 by American Society of Hematology         Online ISSN: 1528-0020