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  3. Measurable Residual Disease and Fusion Partner Independently Predict Survival and Relapse Risk in Childhood KMT2A-Rearranged Acute Myeloid Leukemia: A Study by the International Berlin-Frankfurt-Münster Study Group.

Measurable Residual Disease and Fusion Partner Independently Predict Survival and Relapse Risk in Childhood KMT2A-Rearranged Acute Myeloid Leukemia: A Study by the International Berlin-Frankfurt-Münster Study Group.

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Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • van Weelderen, Romy E
  • Klein, Kim
  • Harrison, Christine J
  • Jiang, Yilin
  • Abrahamsson, Jonas
  • Arad-Cohen, Nira
  • Bart-Delabesse, Emmanuelle
  • Buldini, Barbara
  • De Moerloose, Barbara
  • Dworzak, Michael N
  • Elitzur, Sarah
  • Gerbing, Robert B
  • Goemans, Bianca F
  • de Groot-Kruseman, Hester A
  • Guest, Erin
  • Ha, Shau-Yin
  • Hasle, Henrik
  • Kelaidi, Charikleia
  • Lapillonne, Helene
  • Leverger, Guy
  • Locatelli, Franco
  • Masetti, Riccardo
  • Miyamura, Takako
  • Noren-Nystrom, Ulrika
  • Polychronopoulou, Sophia
  • Rasche, Mareike
  • Rubnitz, Jeffrey E
  • Stary, Jan
  • Tierens, Anne
  • Tomizawa, Daisuke
  • Zwaan, C Michel
  • Kaspers GJL

Grupos

Abstract

PURPOSE: A previous study by the International Berlin-Frankfurt-Münster Study Group (I-BFM-SG) on childhood KMT2A-rearranged (KMT2A-r) AML demonstrated the prognostic value of the fusion partner. This I-BFM-SG study investigated the value of flow cytometry-based measurable residual disease (flow-MRD) and evaluated the benefit of allogeneic stem-cell transplantation (allo-SCT) in first complete remission (CR1) in this disease. METHODS: A total of 1,130 children with KMT2A-r AML, diagnosed between January 2005 and December 2016, were assigned to high-risk (n = 402; 35.6%) or non-high-risk (n = 728; 64.4%) fusion partner-based groups. Flow-MRD levels at both end of induction 1 (EOI1) and 2 (EOI2) were available for 456 patients and were considered negative (<0.1%) or positive (=0.1%). End points were 5-year event-free survival (EFS), cumulative incidence of relapse (CIR), and overall survival (OS). RESULTS: The high-risk group had inferior EFS (30.3% high risk v 54.0% non-high risk; P < .0001), CIR (59.7% v 35.2%; P < .0001), and OS (49.2% v 70.5%; P < .0001). EOI2 MRD negativity was associated with superior EFS (n = 413; 47.6% MRD negativity v n = 43; 16.3% MRD positivity; P < .0001) and OS (n = 413; 66.0% v n = 43; 27.9%; P < .0001), and showed a trend toward lower CIR (n = 392; 46.1% v n = 26; 65.4%; P = .016). Similar results were obtained for patients with EOI2 MRD negativity within both risk groups, except that within the non-high-risk group, CIR was comparable with that of patients with EOI2 MRD positivity. Allo-SCT in CR1 only reduced CIR (hazard ratio, 0.5 [95% CI, 0.4 to 0.8]; P = .00096) within the high-risk group but did not improve OS. In multivariable analyses, EOI2 MRD positivity and high-risk group were independently associated with inferior EFS, CIR, and OS. CONCLUSION: EOI2 flow-MRD is an independent prognostic factor and should be included as risk stratification factor in childhood KMT2A-r AML. Treatment approaches other than allo-SCT in CR1 are needed to improve prognosis.

Datos de la publicación

ISSN/ISSNe:
0732-183X, 1527-7755

JOURNAL OF CLINICAL ONCOLOGY  LIPPINCOTT WILLIAMS & WILKINS

Tipo:
Article
Páginas:
2202120-2202120
PubMed:
36996387
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
9,378 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 55

Citas Recibidas en Scopus: 49

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Keywords

  • AIEOP-AML 2002/01; FLOW-CYTOMETRY; CHILDREN; CHEMOTHERAPY; ADOLESCENTS; TRIAL; TRANSPLANTATION; INDUCTION

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