急性髓系白血病患者诱导化疗后第七或第八天微小残留病检测的预后意义

OBJECTIVE: To investigate the impact of minimal residual disease (MRD) by multiparameter flow cytometry (MPFC) during aplasia on efficacy and prognosis of de novo acute myeloid leukemia (AML) (non M(3)) patients. METHODS: The MRD data by 8-color MPFC during aplasia (day 14–15 of induction therapy) in 85 de novo AML (non M(3)) patients and the MRD impact on efficacy and prognosis were retrospectively analyzed. RESULTS: Data of 85 patients, including 42 males (49.4%) and 43 females (50.6%), were collected, with a median age of 35 (15–54) years. The median MRD by MPFC during aplasia was 0.58% (0–81.11%), and 70 (82.4%) patients achieved complete remission (CR) after first induction chemotherapy. The cutoff of MRD by receiver operating characteristic (ROC) analysis was 2.305% (Se= 0.867, Sp=0.800). The CR rate after one course was significantly higher in patients with MRD<2.305% [96.6% (56/58)] than in patients with MRD≥2.305%[51.9% (14/27)] (χ(2)=22.348, P<0.001); no significant difference with respect to relapse-free survival rate (χ(2)=1.08, P=0.299) or overall survival rate (χ(2)=0.42, P=0.516) could be demonstrated for the comparison of the two groups. Multivariates analysis showed MRD divided by 2.305% was the only independent prognostic factor for CR after one course (OR= 21.560, 95% CI 4.129–112.579, P<0.001). CONCLUSION: Flow cytometric MRD divided by 2.305% during aplasia could be a predictor of efficacy after first induction therapy in AML patients.