In a nutshell
This study looked at the effect of remaining leukemia cells (present in bone marrow during remission) on stem cell transplant outcomes in acute myeloid leukemia patients. The study concluded that the presence of leukemia cells prior to stem cell transplantation has a negative effect on patient outcomes.
Some background
Adult acute myeloid leukemia (AML) is a cancer of the blood and bone marrow. In AML, white blood cells do not mature normally. The goal of AML treatment is remission. Remission is defined as having a normal blood count with no signs or symptoms of leukemia in the body and having less than 5% leukemia cells in the bone marrow. Sometimes patients require a stem cell transplant during remission. This replaces cells that are abnormal or destroyed by the cancer treatment.
Patients who have remaining leukemia cells during remission have minimal residual disease (MRD). A number of studies have shown worse outcomes in patients with MRD prior to stem cell transplantation compared to patients who do not.
Methods & findings
This study examined the results of 19 prior studies, including 1,431 patients.
Patients with MRD were 2.76 times more likely to have shorter leukemia-free survival (time from treatment until leukemia returns). Patients with MRD were 2.36 times more likely to have a shorter overall survival (time from treatment until death from any cause). MRD was associated with a 3.65-fold increased risk of disease relapse.
MRD was not associated with mortality rates in patients who did not relapse. These results were no affected by the intensity of treatment or patient age.
The bottom line
The authors suggest that there is a strong link between pre-stem cell transplant MRD and post-transplant outcomes in AML.
What’s next?
If you are concerned about outcomes after stem cell treatment please discuss this with your doctor.
Published By :
Haematologica
Date :
May 01, 2017
