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A retrospective study of the correlation of in vitro chemosensitivity using ATP-TCA with patient clinical outcomes in acute myeloid leukemia

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Abstract

Purpose

To evaluate the predictive value of the in vitro chemosensitivity using ATP-TCA method to compare the clinical efficacy of patients with AML.

Methods

Bone marrow or peripheral blood samples were collected from 65 patients with AML, and the in vitro chemosensitivity of four drugs (cytarabine/idarubicin/decitabine/aclacinomycin) was measured by an ATP-tumor chemosensitivity assay.

Results

Aclacinomycin and cytarabine had the highest chemosensitivity rates (66.7%, 8/12 and 58.5%, 38/65, respectively), while idarubicin and decitabine had rates of 6.5% (3/46) and 0% (0/35), respectively. Complete remission (CR) was achieved in 66.2% (43/65) of patients, and there was a statistically significant correlation between CR and in vitro chemosensitivity for cytarabine (47.7% vs 18.5%, p = 0.002), but not for the anthracyclines (p = 0.950). In addition, three other factors significantly correlated with CR: disease status (p = 0.005), FLT3-ITD/TKD mutation (p = 0.003) and chemotherapy regimens (p = 0.004). Furthermore, multiple logistic regression analysis revealed that the sensitivity of cytarabine was one of the significant risk factors for CR [hazard ratio (HR) = 5.52; 95% confidence interval (CI) = 1.47–20.70; p = 0.011].

Conclusions

The in vitro chemosensitivity as tested by ATP-TCA demonstrated a significant correlation with CR for chemotherapy and can be a useful tool to optimize personalized treatments for patients with AML.

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Acknowledgements

This study was supported by the National Key New Drug Creation Special Program (2017ZX09304-021), the Suzhou Key Laboratory of Drug Clinical Research and Personalized Medicine (SZS201719), and the Science and Technology Plan of Suzhou (SYSD2017150).

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Authors and Affiliations

  1. Department of Clinical Pharmacology, The First Affiliated Hospital of Soochow University, Suzhou, China

    Fan Xia, Sheng Ma, Yicong Bian, Di Yu, Chenrong Huang & Liyan Miao

  2. Institute for Interdisciplinary Drug Research and Translational Sciences, College of Pharmaceutical Science, Soochow University, Suzhou, China

    Chenrong Huang & Liyan Miao

  3. Department of Quality Management, The First Affiliated Hospital of Soochow University, Suzhou, China

    WenXia Ma

  4. Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China

    Miao Miao

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  1. Fan Xia
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Correspondence to Chenrong Huang or Liyan Miao.

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Xia, F., Ma, S., Bian, Y. et al. A retrospective study of the correlation of in vitro chemosensitivity using ATP-TCA with patient clinical outcomes in acute myeloid leukemia. Cancer Chemother Pharmacol 85, 509–515 (2020). https://doi.org/10.1007/s00280-019-03973-5

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