Abstract
We analyzed the impact of pretransplant MRD level in bone marrow measured by flow cytometry using "different from normal" method on outcomes for 189 AML patients (108 males; median age, 58 (21-80)years). All patients were subdivided into negative (n=96), "low" (0.1%-0.5%, n=32), and "high" MRD (>0.5%, n=61) groups. In multivariate analysis, the hazard ratios for "high" and "low" MRD levels related to MRD negativity were 7.9 (95% CI 3.5-18.1, P<.001) and 5.4 (95% CI 2.1-14, P=.0058) for relapse; 2.3 (95% CI 1.3-4.1, P=.006) and 1.6 (95% CI 0.82-3.3, P=.16) for OS; and 2.8 (95% CI 1.7-4.7, P<.001) and 2.2 (95% CI 1.1-4.2, P=.02) for LFS, respectively. We found no significant impact of "low" MRD level on relapses (0.68, 95% CI 0.33-1.4, P=.30), OS (0.72, 95% CI: 0.36-1.5, P=.36) and LFS (0.79, 95% CI: 0.42-1.5, P=.46) related to "high" MRD group. Presence of detectable MRD was indicative for a high relapse risk, low LFS and OS. "Low" MRD level showed no significant impact on relapse, LFS and OS related to "high" MRD group.
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