Prognostic significance of flow cytometric residual disease, dysregulated neutrophils/monocytes, and hematogones in adult acute myeloid leukemia in first remission

Sung Chao Chu, Tso Fu Wang, Yu Chieh Su, Ruey Ho Kao, Yi Feng Wu, Dian Kun Li, Szu Chin Li, Chi Cheng Li, Denise A. Wells, Michael R. Loken

Research output: Contribution to journalArticle

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Abstract

Fifty-one consecutive non-M3 acute myeloid leukemia (AML) patients who had achieved morphologic complete remission (mCR) after induction chemotherapy were enrolled in the present study. Three characteristics of bone marrow (BM) composition analyzed by flow cytometry were combined to determine the prognostic impact. A standardized panel of reagents was used to detect residual disease of aberrant myeloid progenitor cells (RD), identify neutrophils/monocytes with dysregulated immunophenotype (dysregulated neutro/mono) and quantify the appearance of CD34+ B-progenitor-related cluster (hematogones) simultaneously in post-induction BM of adult AML patients. Patients who had detectable RD ≥0.2 % exhibited significantly lower median leukemia-free survival (LFS) than those who did not (13.5 vs. 48.0 months; P = 0.042). Dysregulated neutro/mono abnormalities assessed by this flow cytometric scoring system (FCSS ≥2) predicted shorter LFS (8.0 vs. 39.0 months; P = 0.008). While B-progenitor-related cluster size ≥5 % predicted improved outcome, with longer LFS (not reached vs. 13.5 months; P = 0.023) and better overall survival (not reached vs. 24.0 months; P = 0.027). The proposed RD/dysregulated neutro/mono/hematogones score showed a new risk groups with different LFS in the overall patients (P = 0.0006) as well as in the subgroup of intermediate cytogenetic risk (P = 0.001). The RD/dysregulated neutro/mono/hematogones score assessed by flow cytometry for adult AML in mCR may offer a rapid and practical risk assessment providing better refinement in risk-adapted management after induction chemotherapy.

Original languageEnglish
Pages (from-to)296-304
Number of pages9
JournalInternational Journal of Hematology
Volume99
Issue number3
DOIs
Publication statusPublished - Jan 1 2014
Externally publishedYes

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Acute Myeloid Leukemia
Monocytes
Neutrophils
Leukemia
Survival
Induction Chemotherapy
Flow Cytometry
Bone Marrow
Myeloid Progenitor Cells
Remission Induction
Risk Management
Cytogenetics

Keywords

  • Acute myeloid leukemia
  • Flow cytometry
  • Hematogones
  • Residual disease

ASJC Scopus subject areas

  • Hematology

Cite this

Prognostic significance of flow cytometric residual disease, dysregulated neutrophils/monocytes, and hematogones in adult acute myeloid leukemia in first remission. / Chu, Sung Chao; Wang, Tso Fu; Su, Yu Chieh; Kao, Ruey Ho; Wu, Yi Feng; Li, Dian Kun; Li, Szu Chin; Li, Chi Cheng; Wells, Denise A.; Loken, Michael R.

In: International Journal of Hematology, Vol. 99, No. 3, 01.01.2014, p. 296-304.

Research output: Contribution to journalArticle

Chu, Sung Chao ; Wang, Tso Fu ; Su, Yu Chieh ; Kao, Ruey Ho ; Wu, Yi Feng ; Li, Dian Kun ; Li, Szu Chin ; Li, Chi Cheng ; Wells, Denise A. ; Loken, Michael R. / Prognostic significance of flow cytometric residual disease, dysregulated neutrophils/monocytes, and hematogones in adult acute myeloid leukemia in first remission. In: International Journal of Hematology. 2014 ; Vol. 99, No. 3. pp. 296-304.
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AU - Wu, Yi Feng

AU - Li, Dian Kun

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