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Open Access 01-12-2024 | Acute Myeloid Leukemia | Research

Prognostic significance of multiparametric flow cytometry minimal residual disease at two time points after induction in pediatric acute myeloid leukemia

Authors: Yongzhi Zheng, Lili Pan, Jian Li, Xiaoqin Feng, Chunfu Li, Mincui Zheng, Huirong Mai, Lihua Yang, Yingyi He, Xiangling He, Honggui Xu, Hong Wen, Shaohua Le

Published in: BMC Cancer | Issue 1/2024

Abstract

Background

Prompt response to induction chemotherapy is a prognostic factor in pediatric acute myeloid leukemia. In this study, we aimed to evaluate the prognostic significance of multiparametric flow cytometry-minimal residual disease (MFC-MRD), assessed at the end of the first and second induction courses.

Methods

MFC-MRD was performed at the end of the first induction (TP1) in 524 patients and second induction (TP2) in 467 patients who were treated according to the modified Medical Research Council (UK) acute myeloid leukemia 15 protocol.

Results

Using a 0.1% cutoff level, patients with MFC-MRD at the two time points had lower event-free survival and overall survival. Only the TP2 MFC-MRD level could predict the outcome in a separate analysis of high and intermediate risks based on European LeukemiaNet risk stratification and KMT2A rearrangement. The TP2 MFC-MRD level could further differentiate the prognosis of patients into complete remission or non-complete remission based on morphological evaluation. Multivariate analysis indicated the TP2 MFC-MRD level as an independent adverse prognostic factor for event-free survival and overall survival. When comparing patients with MFC-MRD ≥ 0.1%, those who underwent hematopoietic stem cell transplant during the first complete remission had significantly higher 5-year event-free survival and overall survival and lower cumulative incidence of relapse than those who only received consolidation chemotherapy.

Conclusions

The TP2 MFC-MRD level can predict the outcomes in pediatric patients with acute myeloid leukemia and help stratify post-remission treatment.

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Title: Prognostic significance of multiparametric flow cytometry minimal residual disease at two time points after induction in pediatric acute myeloid leukemia
Authors: Yongzhi Zheng
Lili Pan
Jian Li
Xiaoqin Feng
Chunfu Li
Mincui Zheng
Huirong Mai
Lihua Yang
Yingyi He
Xiangling He
Honggui Xu
Hong Wen
Shaohua Le
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Acute Myeloid Leukemia
Published in: BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-023-11784-4

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Abstract

Background

Methods

Results

Conclusions

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