Minimal Residual Disease Monitoring After Reduced Intensity Conditioning (Ric) Allogeneic Transplantation: May Help To Individualize Post-Transplant Immunotherapeutic Strategies.
BLOOD(2005)
摘要
Abstract We have analyzed the impact of MRD monitoring (detected by flow cytometry) on the outcome of 56 patients undergoing RIC allogeneic SCT. Of them, 67% reached complete remission (CR), 11% partially responded (PR) and 22% progressed or did not respond. MRD assessment after transplant distinguished different risk populations. At day +100, 80% of patients with high MRD levels (>10−2 leukemia asocciatted immunophenotypical cells, LAIP cells) versus 27% of patients with low MRD (<10−4) had relapsed. Accordingly, 3 categories could be clearly idenitified in terms of relapse free survival (RFS) at 5 years: 62% of patients with low MRD levels (<10−4) were event free as compared to only 28% and 20% among patients with intermediate (>10−4 and <10−2) and high MRD (>10−2) (p=0.0047). In multivariate analysis, patients’ age > 60 years (HR: 4,005; 95% CI 1.1–14.1, p=0.03), advanced disease status at transplant (HR: 4,087; 95% CI 1.3–12, p=0.01), failure to develop acute (HR: 4,785; 95% CI 1.2–18, p=0.02) and chronic GVHD (HR: 8,166; 95% CI 2.5–26.1, p=<0.001) and MRD levels, ≥10−4 on day +100 (HR: 5,795; 95% CI 1.7–19.1, p=0.004) adversely influenced RFS. Our study suggests that monitoring of MRD is a useful tool for predicting risk of relapse.
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