Significance of Pre- and Posttransplant Minimal Residual Disease on Transplant Outcomes in Core-Binding Factor Acute Myeloid Leukemia.
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Tokuda Chika, Iwasaki Makoto, Kanda Junya, Kondo Tadakazu, Arai Yasuyuki, Ishikawa Takayuki, Yamamoto Ryusuke, Imada Kazunori, Oku Yuki, Ueda Yasunori, Takatani Ryosuke, Yonezawa Akihito, Iwai Fumie, Yago Kazuhiro, Ikeda Takashi, Yoshitsugu Kanako, Kitano Toshiyuki, Akasaka Takashi, Nohgawa Masaharu, Tanaka Yasuhiro, Itoh Mitsuru, Takeoka Tomoharu, Anzai Naoyuki, Onda Yoshiyuki, Arima Nobuyoshi, Tsunemine Hiroko, Hishizawa Masakatsu, Watanabe Mitsumasa, Hirata Hirokazu, Asagoe Kosuke, Yoshinaga Noriyoshi, Sakamoto Takashi, Yamashita Kouhei, Takaori-Kondo Akifumi, Kyoto Stem Cell Transplantation Group (KSCTG)
Аннотация
METHOD: Using Kyoto Stem Cell Transplantation Group registry data, we included 96 patients who underwent allo-HSCT between 2000 and 2019 for CBF-AML.
RESULTS: To assess MRD, quantitative PCR with GAPDH control was most used. As for pretransplant MRD, 2-year overall survival (OS) and relapse-free survival (RFS) of the weak positive group (50-200 copy/μgRNA) were 66.5% and 67.2%, and these were as unfavorable as those of the strong positive group (> 200 copy/μgRNA, OS; 64.3%, RFS; 54.5%) compared to the negative group (OS; 100%, RFS; 93.3%). In contrast, as regards posttransplant MRD, 2-year OS of patients with lower maximum MRD during approximately half a year post-transplantation period (50-350 copy/μgRNA, 81.5%) was comparable to that of MRD-negative patients (84.5%). In multivariate analysis, higher maximum MRD (> 350 copy/μgRNA) was a significant unfavorable factor toward OS (hazard ratio: 6.3, p = 0.002) compared to negative MRD.
CONCLUSIONS: The interpretation of posttransplant MRD positivity should be approached with caution, particularly in cases with low-level positivity as it might diminish over time.