Monitoring MRD with flow cytometry: an effective method to predict relapse for ALL patients after allogeneic hematopoietic stem cell transplantation
- 28 June 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Hematology
- Vol. 91 (2), 183-192
- https://doi.org/10.1007/s00277-011-1285-1
Abstract
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 FCM-negative (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.Keywords
This publication has 31 references indexed in Scilit:
- Prognostic significance of minimal residual disease detected by a simplified flow cytometric assay during remission induction chemotherapy in children with acute lymphoblastic leukemiaKorean Journal of Pediatrics, 2010
- Treatment of Acute Leukemia with Unmanipulated HLA-Mismatched/Haploidentical Blood and Bone Marrow TransplantationTransplantation and Cellular Therapy, 2009
- Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group studyPublished by American Society of Hematology ,2008
- Non-specific amplification of patient-specific Ig/TCR gene rearrangements depends on the time point during therapy: implications for minimal residual disease monitoringLeukemia, 2007
- Why and how to quantify minimal residual disease in acute lymphoblastic leukemia?Leukemia, 2007
- Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemiaBlood, 2006
- Flow Cytometric Detection of Minimal Residual Disease in Acute Lymphoblastic LeukemiaLeukemia & Lymphoma, 2003
- Prognostic importance of measuring early clearance of leukemic cells by flow cytometry in childhood acute lymphoblastic leukemiaBlood, 2002
- Detection of minimal residual disease (MRD) after bone marrow transplantation (BMT) by multi-parameter flow cytometry (MPFC)Medical Oncology, 1999
- Minimal residula disease status as a predictor of relapse after allogenic bone marrow transplantation for children with acute lymphoblastic leukaemiaBritish Journal of Haematology, 1998