Cargando…

Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation

In patients with t(8;21) acute myeloid leukemia (AML), recurrent minimal residual disease (MRD) measured by RUNX1-RUNX1T1 transcript levels can predict relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study aimed to compare the efficacy of preemptive interferon (IFN...

Descripción completa

Detalles Bibliográficos
Autores principales: Fan, Shuang, Shen, Meng-Zhu, Zhang, Xiao-Hui, Xu, Lan-Ping, Wang, Yu, Yan, Chen-Hua, Chen, Huan, Chen, Yu-Hong, Han, Wei, Wang, Feng-Rong, Wang, Jing-Zhi, Zhao, Xiao-Su, Qin, Ya-Zhen, Chang, Ying-Jun, Liu, Kai-Yan, Huang, Xiao-Jun, Mo, Xiao-Dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770808/
https://www.ncbi.nlm.nih.gov/pubmed/35070977
http://dx.doi.org/10.3389/fonc.2021.773394
_version_ 1784635449986252800
author Fan, Shuang
Shen, Meng-Zhu
Zhang, Xiao-Hui
Xu, Lan-Ping
Wang, Yu
Yan, Chen-Hua
Chen, Huan
Chen, Yu-Hong
Han, Wei
Wang, Feng-Rong
Wang, Jing-Zhi
Zhao, Xiao-Su
Qin, Ya-Zhen
Chang, Ying-Jun
Liu, Kai-Yan
Huang, Xiao-Jun
Mo, Xiao-Dong
author_facet Fan, Shuang
Shen, Meng-Zhu
Zhang, Xiao-Hui
Xu, Lan-Ping
Wang, Yu
Yan, Chen-Hua
Chen, Huan
Chen, Yu-Hong
Han, Wei
Wang, Feng-Rong
Wang, Jing-Zhi
Zhao, Xiao-Su
Qin, Ya-Zhen
Chang, Ying-Jun
Liu, Kai-Yan
Huang, Xiao-Jun
Mo, Xiao-Dong
author_sort Fan, Shuang
collection PubMed
description In patients with t(8;21) acute myeloid leukemia (AML), recurrent minimal residual disease (MRD) measured by RUNX1-RUNX1T1 transcript levels can predict relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study aimed to compare the efficacy of preemptive interferon (IFN)-α therapy and donor lymphocyte infusion (DLI) in patients with t(8;21) AML following allo-HSCT. We also evaluated the appropriate method for patients with different levels of RUNX1-RUNX1T1 transcripts. In this retrospective study, consecutive patients who had high-risk t(8;21) AML and received allo-HSCT were enrolled. The inclusion criteria were as follows: (1) age ≤65 years; (2) regained MRD positive following allo-HSCT. MRD positive was defined as the loss of a ≥4.5-log reduction and/or <4.5-log reduction in the RUNX1-RUNX1T1 transcripts, and high-level, intermediate-level, and low-level MRDs were, respectively, defined as <2.5-log, 2.5−3.5-log, and 3.5−4.5-log reductions in the transcripts compared with the pretreatment baseline level. Patients with positive RUNX1-RUNX1T1 could receive preemptive IFN-α therapy or DLI, which was primarily based on donor availability and the intentions of physicians and patients. The patients received recombinant human IFN-α-2b therapy by subcutaneous injection twice a week every 4 weeks. IFN-α therapy was scheduled for six cycles or until the RUNX1-RUNX1T1 transcripts were negative for at least two consecutive tests. The rates of MRD turning negative for patients with low-level, intermediate-level, and high-level RUNX1-RUNX1T1 receiving IFN-α were 87.5%, 58.1%, and 22.2%, respectively; meanwhile, for patients with intermediate-level and high-level RUNX1-RUNX1T1 receiving DLI, the rates were 50.0% and 14.3%, respectively. For patients with low-level and intermediate-level RUNX1-RUNX1T1, the probability of overall survival at 2 years was higher in the IFN-α group than in the DLI group (87.6% vs. 55.6%; p = 0.003). For patients with high levels of RUNX1-RUNX1T1, the probability of overall survival was comparable between the IFN-α and DLI groups (53.3% vs. 83.3%; p = 0.780). Therefore, patients with low-level and intermediate-level RUNX1-RUNX1T1 could benefit more from preemptive IFN-α therapy compared with DLI. Clinical outcomes were comparable between preemptive IFN-α therapy and DLI in patients with high-level RUNX1-RUNX1T1; however, they should be further improved.
format Online
Article
Text
id pubmed-8770808
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-87708082022-01-21 Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation Fan, Shuang Shen, Meng-Zhu Zhang, Xiao-Hui Xu, Lan-Ping Wang, Yu Yan, Chen-Hua Chen, Huan Chen, Yu-Hong Han, Wei Wang, Feng-Rong Wang, Jing-Zhi Zhao, Xiao-Su Qin, Ya-Zhen Chang, Ying-Jun Liu, Kai-Yan Huang, Xiao-Jun Mo, Xiao-Dong Front Oncol Oncology In patients with t(8;21) acute myeloid leukemia (AML), recurrent minimal residual disease (MRD) measured by RUNX1-RUNX1T1 transcript levels can predict relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study aimed to compare the efficacy of preemptive interferon (IFN)-α therapy and donor lymphocyte infusion (DLI) in patients with t(8;21) AML following allo-HSCT. We also evaluated the appropriate method for patients with different levels of RUNX1-RUNX1T1 transcripts. In this retrospective study, consecutive patients who had high-risk t(8;21) AML and received allo-HSCT were enrolled. The inclusion criteria were as follows: (1) age ≤65 years; (2) regained MRD positive following allo-HSCT. MRD positive was defined as the loss of a ≥4.5-log reduction and/or <4.5-log reduction in the RUNX1-RUNX1T1 transcripts, and high-level, intermediate-level, and low-level MRDs were, respectively, defined as <2.5-log, 2.5−3.5-log, and 3.5−4.5-log reductions in the transcripts compared with the pretreatment baseline level. Patients with positive RUNX1-RUNX1T1 could receive preemptive IFN-α therapy or DLI, which was primarily based on donor availability and the intentions of physicians and patients. The patients received recombinant human IFN-α-2b therapy by subcutaneous injection twice a week every 4 weeks. IFN-α therapy was scheduled for six cycles or until the RUNX1-RUNX1T1 transcripts were negative for at least two consecutive tests. The rates of MRD turning negative for patients with low-level, intermediate-level, and high-level RUNX1-RUNX1T1 receiving IFN-α were 87.5%, 58.1%, and 22.2%, respectively; meanwhile, for patients with intermediate-level and high-level RUNX1-RUNX1T1 receiving DLI, the rates were 50.0% and 14.3%, respectively. For patients with low-level and intermediate-level RUNX1-RUNX1T1, the probability of overall survival at 2 years was higher in the IFN-α group than in the DLI group (87.6% vs. 55.6%; p = 0.003). For patients with high levels of RUNX1-RUNX1T1, the probability of overall survival was comparable between the IFN-α and DLI groups (53.3% vs. 83.3%; p = 0.780). Therefore, patients with low-level and intermediate-level RUNX1-RUNX1T1 could benefit more from preemptive IFN-α therapy compared with DLI. Clinical outcomes were comparable between preemptive IFN-α therapy and DLI in patients with high-level RUNX1-RUNX1T1; however, they should be further improved. Frontiers Media S.A. 2022-01-06 /pmc/articles/PMC8770808/ /pubmed/35070977 http://dx.doi.org/10.3389/fonc.2021.773394 Text en Copyright © 2022 Fan, Shen, Zhang, Xu, Wang, Yan, Chen, Chen, Han, Wang, Wang, Zhao, Qin, Chang, Liu, Huang and Mo https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Fan, Shuang
Shen, Meng-Zhu
Zhang, Xiao-Hui
Xu, Lan-Ping
Wang, Yu
Yan, Chen-Hua
Chen, Huan
Chen, Yu-Hong
Han, Wei
Wang, Feng-Rong
Wang, Jing-Zhi
Zhao, Xiao-Su
Qin, Ya-Zhen
Chang, Ying-Jun
Liu, Kai-Yan
Huang, Xiao-Jun
Mo, Xiao-Dong
Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation
title Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation
title_full Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation
title_fullStr Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation
title_full_unstemmed Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation
title_short Preemptive Immunotherapy for Minimal Residual Disease in Patients With t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation
title_sort preemptive immunotherapy for minimal residual disease in patients with t(8;21) acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770808/
https://www.ncbi.nlm.nih.gov/pubmed/35070977
http://dx.doi.org/10.3389/fonc.2021.773394
work_keys_str_mv AT fanshuang preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT shenmengzhu preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT zhangxiaohui preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT xulanping preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT wangyu preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT yanchenhua preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT chenhuan preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT chenyuhong preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT hanwei preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT wangfengrong preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT wangjingzhi preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT zhaoxiaosu preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT qinyazhen preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT changyingjun preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT liukaiyan preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT huangxiaojun preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation
AT moxiaodong preemptiveimmunotherapyforminimalresidualdiseaseinpatientswitht821acutemyeloidleukemiaafterallogeneichematopoieticstemcelltransplantation