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Residual disease detected by multidimensional flow cytometry shows prognostic significance in childhood acute myeloid leukemia with intermediate cytogenetics and negative FLT3-ITD: a report from the Tokyo Children’s Cancer Study Group

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Abstract

Residual disease (RD) after induction chemotherapy may predict clinical outcome in acute myeloid leukemia (AML). In the present study, we investigated the prognostic significance of RD detected by multidimensional flow cytometry (MDF) among 34 children treated for AML in a clinical trial (JPLSG AML-05) in Japan. Bone marrow samples were analyzed at the points of the end of the first induction course (BMA-1) and second induction course (BMA-2) by MDF. RD was evaluated by detecting the immature cells showing abnormal antigen expression pattern; CD34+, CD15+, CD7+. Thirteen (39.4 %) of 34 patients at BMA-1 and 8 (27.6 %) of 34 at BMA-2 had RD levels ≥0.1 %. There was no significant difference in 3y-EFS and 3y-OS between patients with RD levels ≥0.1 % and those with RD levels <0.1 % (53.8 versus 70.0 %, P = 0.30 and 50.0 versus 66.7 %, P = 0.27, respectively). However, IR cytogenetics and negative FLT3-ITD patients with RD levels ≥0.1 % exhibited significantly lower 3y-EFS and 3y-OS than those with RD levels <0.1 % (33.3 versus 83.3 %, P = 0.02 and 20.0 versus 76.9 %, P = 0.005, respectively). Our study suggests that RD shows prognostic relevance in pediatric patients with IR cytogenetics and negative FLT3-ITD AML.

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Authors and Affiliations

  1. Department of Pediatrics, St.Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Dai Keino & Akitoshi Kinoshita

  2. Division of Leukemia and Lymphoma, Childern’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan

    Daisuke Tomizawa, Chikako Kiyotani & Tomoo Osumi

  3. Department of Pediatrics, Toho University, Tokyo, Japan

    Hiroyuki Takahashi & Akira Ohara

  4. Department of Pediatrics, Teikyo University Mizonokuchi Hospital, Kawasaki, Kanagawa, Japan

    Kohmei Ida

  5. Department of Pediatrics, Dokkyo Medical University, Mibu, Tochigi, Japan

    Hidemitsu Kurosawa

  6. Division of Pediatric Hematology and Oncology, Ibaraki Children’s Hospital, Mito, Ibaraki, Japan

    Kazutoshi Koike

  7. Department of Pediatrics, Teikyo University Chiba Medical Center, Chiba, Japan

    Setsuo Ota

  8. Department of Hematology/Oncology, Kanagawa Children’s Medical Center, Yokohama, Kanagawa, Japan

    Noriyuki Iwasaki

  9. Department of Pediatrics and Adolescent Medicine, Juntendo University School of Medicine, Tokyo, Japan

    Junya Fujimura

  10. Department of Hematology/Oncology, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan

    Yuki Yuza

  11. Department of Pediatrics, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan

    Shohei Yamamoto & Keiichi Isoyama

  12. Department of Pediatrics, Nippon Medical School, Tokyo, Japan

    Takahiro Ueda

  13. Division of Stem Cell Processing, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Shinji Mochizuki

  14. Department of Hematology/Oncology, Saitama Children’s Medical Center, Saitama, Japan

    Ryoji Hanada

  15. Department of Pediatrics, National Hospital Organization Osaka Medical Center, Osaka, Japan

    Akio Tawa

  16. Department of Pediatrics, St. Luke’s International Hospital, Tokyo, Japan

    Atsushi Manabe

  17. ReproCELL Incorporated, Yokohama, Japan

    Yoichi Toguchi

Authors
  1. Dai Keino
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  2. Akitoshi Kinoshita
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  3. Daisuke Tomizawa
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  13. Shohei Yamamoto
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  14. Tomoo Osumi
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  15. Takahiro Ueda
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  18. Ryoji Hanada
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  19. Akio Tawa
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  20. Atsushi Manabe
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  21. Yoichi Toguchi
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  22. Akira Ohara
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Corresponding author

Correspondence to Dai Keino.

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Conflict of interest

This study was financially supported by Kyowa Hakko Kirin Co. Ltd.

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Keino, D., Kinoshita, A., Tomizawa, D. et al. Residual disease detected by multidimensional flow cytometry shows prognostic significance in childhood acute myeloid leukemia with intermediate cytogenetics and negative FLT3-ITD: a report from the Tokyo Children’s Cancer Study Group. Int J Hematol 103, 416–422 (2016). https://doi.org/10.1007/s12185-016-1937-y

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  • DOI: https://doi.org/10.1007/s12185-016-1937-y

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