Identifying leukemia‐associated immunophenotype‐based individualized minimal residual disease in acute myeloid leukemia and its prognostic significance

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Abstract
Based on the leukemia‐associated immunophenotypes (LAIPs), minimal residual disease (MRD) related to the outcome can be detected by multiparameter flow cytometry in acute myeloid leukemia (AML) patients. Although 0.1% was commonly used as a cutoff value, measurable MRD or MRD level below 0.1% has also been associated with prognostic significance and more sensitive thresholds (−5 to 5.71 × 10−4. The baseline level of each LAIP was considered as the individual threshold for MRD assessment. MRD statuses stratified by 0.1% and individual threshold were termed as 0.1%‐MRD and individual‐MRD, respectively. The patients of individual‐MRDneg showed significantly better survival compared with those of 0.1%‐MRDneg/individual‐MRDpos or 0.1%‐MRDpos. Multivariate analysis showed that when time points of complete remission, post the first and second consolidation courses, were considered, only individual‐MRD post second consolidation presented independent prognostic value. Notably, in patients of cytogenetic/molecular low‐risk (LR) or intermediate‐risk (IR), the individual‐MRD status could identify the patients with significantly different outcomes, while 0.1%‐MRD status could not. Furthermore, among the patients of the LR or IR group which received chemotherapy only, those with individual‐MRDneg status presented favorable survival, which was comparable with that of the patients accepted allogeneic hematopoietic stem cell transplantation (ASCT). This approach is useful in the selection of an ASCT strategy for clinical practice.
Funding Information
  • National Natural Science Foundation of China (81270619, 81470311, 81670137)

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