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Prepublished online as a Blood First Edition Paper on July 3, 2003; DOI 10.1182/blood-2003-04-1309.
Submitted April 28, 2003
Accepted June 24, 2003
Effect of circulating blasts at time of complete remission on subsequent relapse-free survival time in newly-diagnosed AML
Elihu H Estey*, Peter F Thall, Xuemei Wang, Srdan Verstovsek, Jorge Cortes, and Hagop M Kantarjian
Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
* Corresponding author; email: ehestey{at}mdanderson.org.
Standardized criteria for complete remission (CR) in AML require the absence of peripheral blood blasts (PBB). However, M.D. Anderson (MDA) criteria for CR (CR-MDA), while including the other requirements for CR, have not included the PBB count. We exploit this difference to assess the effect of PBB at the time of CR-MDA on relapse-free survival (RFS) time. 80% of the 533 patients with newly-diagnosed AML or RAEB entering CR-MDA from 1995- 2000 had no PBB at time of CR-MDA. 93% of the remaining patients, who thus had CR-MDA but not standard CR, had 1-5% PBBs at this time. Multivariate analyses, using both conventional and Bayesian approaches, indicated that PBB had no effect on RFS. For all patients and for the subgroups given and not given G-CSF, the 95% credible interval for the relative risk of failure in the PBB group was nearly centered at 1.0. Thus, our data do not support use of PBB in defining CR in newly-diagnosed AML.
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