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The significance of peri-transplantation minimal residual disease assessed by multiparameter flow cytometry on outcomes for adult AML patients receiving haploidentical allografts

Bone Marrow Transplantation volume 54, pages 567–577 (2019)Cite this article

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Abstract

A retrospective study (n = 460) was performed to assess the relationship between minimal residual disease (MRD) and transplant outcomes in a haplo-stem cell transplantation (SCT) setting. Patients from the pre-MRDneg group and the pre-MRDpos group had comparable outcomes. Compared to post-MRDneg patients, post-MRDpos patients had a higher incidence of relapse (100.0% vs. 8.3%, p < 0.001), lower incidences of overall survival (OS) (16.9% vs. 78.2%, p < 0.001) and leukemia-free survival (LFS) (0% vs. 76.5%, p < 0.001), and comparable probability of NRM (13.4% vs. 16.9%, p = 0.560). In a second set of analyses, all adult AML patients undergoing haplo-SCT were classified into the MRDneg/MRDneg group, the MRD decreasing group, and the MRD increasing group according to MRD dynamics by flow cytometry peri-SCT. Compared to the other two groups, patients from the MRD increasing group had higher cumulative incidences of relapse (MRD increasing, 100.0%; MRDneg/MRDneg, 9.6%; MRD decreasing, 19.2%; p < 0.001) and worse probabilities of OS (MRD increasing, 28.5%; MRDneg/MRDneg, 76.3%; MRD decreasing, 76.0%; p < 0.001) and LFS (MRD increasing, 0.0%; MRDneg/MRDneg, 73.9%; MRD decreasing, 74.0%; p < 0.001). The results indicated that haploidentical allografts might have a beneficial anti-leukemia effect in eradicating pretransplantation MRD, and MRD assessment peri-SCT is useful for risk stratification from a practical perspective.

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Acknowledgments

We thank all the faculty members that participated in these studies. We would also like to thank American Journal Experts (www.aje.com) for the assistance in editing this manuscript.

Author contributions

Contribution: Y.-J.C. designed the study; J. L, R. M, and Y.-J.C. collected data; J. L and Y.-J.C. analyzed the data and drafted the manuscript; all authors contributed to data interpretation, manuscript preparation, and approval of the final version.

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Authors and Affiliations

  1. Peking University People’s Hospital & Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 South Street of Xizhimen, Xicheng District, Beijing, 100044, P.R. China

    Jing Liu, Rui Ma, Yan-Rong Liu, Lan-Ping Xu, Xiao-Hui Zhang, Huan Chen, Yu-Hong Chen, Feng-Rong Wang, Wei Han, Yu-Qian Sun, Chen-Hua Yan, Fei-Fei Tang, Xiao-Dong Mo, Kai-Yan Liu, Qiao-Zhen Fan, Xiao-Jun Huang & Ying-Jun Chang

  2. Peking-Tsinghua Center for Life Sciences, Beijing, 100871, China

    Xiao-Jun Huang

  3. Collaborative Innovation Center of Hematology, Peking University, Beijing, China

    Xiao-Jun Huang & Ying-Jun Chang

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Correspondence to Ying-Jun Chang.

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Liu, J., Ma, R., Liu, YR. et al. The significance of peri-transplantation minimal residual disease assessed by multiparameter flow cytometry on outcomes for adult AML patients receiving haploidentical allografts. Bone Marrow Transplant 54, 567–577 (2019). https://doi.org/10.1038/s41409-018-0300-8

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