Detection of measurable residual disease may better predict outcomes than mutations based on next‐generation sequencing in acute myeloid leukaemia with biallelic mutations of CEBPA. (23rd February 2020)

• Record Type: Journal Article
• Authors: Wang, Jing; Lu, RunQing; Wu, Ying; Jia, JinSong; Gong, Lizhong; Liu, XiaoHong; Lu, ShengYe; Wang, Yu; Yan, ChenHua; Liu, KaiYan; Zhang, XiaoHui; Xu, LanPing; Jiang, Qian; Zhao, XiaoSu; Shi, HongXia; Lai, YueYun; Huang, XiaoJun; Ruan, GuoRui; Jiang, Hao
• Is Part Of: British journal of haematology. Volume 190:Number 4(2020)
• Page Start: 533
• Page End: 544
• Publication Date: 2020-02-23
• Subjects: acute myeloid leukaemia with biallelic CEBPA mutations -- next‐generation sequencing -- multiparameter flow cytometric measurable residual disease -- allogeneic stem cell transplantation -- chemotherapy; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.16535
• Languages: English
• ISSNs: 0007-1048

Abstract

Summary: Acute myeloid leukaemia (AML) patients with biallelic mutations of CEBPA (bi CEBPA) have a 30–50% relapse rate. This study established the value of mutations based on next‐generation sequencing (NGS) and multiparameter flow cytometric measurable residual disease (MFC‐MRD) detection and compared the outcomes. From 2014 to 2018, 124 newly diagnosed bi CEBPA AML patients were treated. The median age was 37·5 (16–69) years. The 3‐year cumulative incidence of relapse (CIR), relapse‐free survival (RFS) and overall survival (OS) were 33·0%, 64·7% and 84·3%, respectively. Patients without additional mutations and with GATA2 mutations were defined as 'NGS low risk', which was the only favourable independent factor for CIR and RFS of pretreatment parameters. Patients with sustained positive MRD after two consolidation cycles and MRD negative losses at any time were defined as 'MRD high risk', which was the only poor independent factor for CIR, RFS and OS, including pretreatment and post‐treatment parameters. In CR2 and non‐remission patients who underwent allo‐HSCT, superior OS was achieved. We conclude that NGS low risk was a favourable factor in the analysis of pretreatment parameters. MRD risk stratification was an independent prognostic factor in pretreatment and post‐treatment parameters. Relapsed patients still have a favourable outcome followed by allo‐HSCT.