Monitoring MRD with flow cytometry: an effective method to predict relapse for ALL patients after allogeneic hematopoietic stem cell transplantation
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Xiao-Su Zhao & Yan-Rong Liu & Hong-Hu Zhu & Lan-Ping Xu & Dai-Hong Liu & Kai-Yan Liu & Xiao-Jun Huang
- چاپ و سال / کشور: 2011
Description
This study evaluated the prognostic value of minimal residual disease (MRD) monitoring by four-color flow cytometry (FCM) in patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). MRD was examined with four-color FCM at different time points in 139 patients (including pediatric and adult patients) with ALL after allo- HSCT. Real-time quantitative polymerase chain reaction (RQ-PCR) was applied to evaluate the MRD of Philadelphia chromosome-positive ALL (Ph+ ALL) patients. Patients who were FCM-positive (FCM+) after transplantation had a lower event-free survival (EFS) of 0.54 and a higher cumulative incidence of relapse (CIR) of 0.54 compared to an EFS of 0.80 and a CIR of 0.08 in FCMnegative (FCM−) patients (EFS, p<0.001; CIR, p<0.001). Similar results were obtained in high-risk patients and Ph+ ALL patients. Moreover, a FCM+ status after the second month post-HSCT (defined as MRD positive) proved to be a predictor of leukemia relapse. Multivariate analysis for EFS, OS and CIR showed that MRD status after transplantation was an independent prognostic factor (p<0.001, p= 0.013, and p<0.001, respectively). A good correlation was found between the MRD results of FCM and RQ-PCR (n= 126 pairs, Spearman r=0.8139, p<0.001). MRD monitoring by four-color FCM post-transplantation is an important tool for relapse prediction in ALL patients. Prompt and appropriate pre-emptive anti-leukemia treatment could be considered based on the status of MRD after HSCT.
Ann Hematol DOI 10.1007/s00277-011-1285-1 Received: 9 March 2011 / Accepted: 16 June 2011
