|Title:||Clinical implications of sequential MRD monitoring by NGS at 2 time points after chemotherapy in patients with AML||Authors:||CHENG-HONG TSAI
Tien, Feng Ming
Wu, Dung Chi
Tseng, Mei Hsuan
Peng, Yen Ling
Hou, Mei Fang
Chuang, Yi Kuang
Liu, Ming Chih
|Issue Date:||17-May-2021||Publisher:||American Society of Hematology||Journal Volume:||5||Journal Issue:||10||Start page/Pages:||2456||Source:||Blood Advances||Abstract:||
Next-generation sequencing (NGS) has been applied to measurable/minimal residual disease (MRD) monitoring after induction chemotherapy in patients with acute myeloid leukemia (AML), but the optimal time point for the test remains unclear. In this study, we aimed to investigate the clinical significance of NGS MRD at 2 different time points. We performed targeted NGS of 54 genes in bone marrow cells serially obtained at diagnosis, first complete remission (first time point), and after the first consolidation chemotherapy (second time point) from 335 de novo AML patients. Excluding DNMT3A, TET2, and ASXL1 mutations, which are commonly present in individuals with clonal hematopoiesis of indeterminate potential, MRD could be detected in 46.4% of patients at the first time point (MRD1st), and 28.9% at the second time point (MRD2nd). The patients with detectable NGS MRD at either time point had a significantly higher cumulative incidence of relapse and shorter relapse-free survival and overall survival. In multivariate analysis, MRD1st and MRD2nd were both independent poor prognostic factors. However, the patients with positive MRD1st but negative MRD2nd had a similar good prognosis as those with negative MRD at both time points. The incorporation of multiparameter flow cytometry and NGS MRD revealed that the presence of NGS MRD predicted poorer prognosis among the patients without detectable MRD by multiparameter flow cytometry at the second time point but not the first time point. In conclusion, the presence of NGS MRD, especially after the first consolidation therapy, can help predict the clinical outcome of AML patients.
DNA methyltransferase 3A; transcription factor RUNX1; acute myeloid leukemia; adolescent; adult; age; aged; Article; ASXL1 gene; bone marrow cell; cancer chemotherapy; cancer prognosis; cancer survival; CEBPA gene; clinical feature; clinical outcome; cohort analysis; consolidation chemotherapy; controlled study; DNMT3A gene; female; flow cytometry; gene; gene mutation; high throughput sequencing; human; human cell; incidence; leukemia relapse; leukemia remission; major clinical study; male; minimal residual disease; monitoring; overall survival; prediction; recurrence free survival; retrospective study; RUNX1 gene; TET2 gene
|Appears in Collections:||醫學系|
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.