Post-induction MRD by FCM and GATA1-PCR are significant prognostic factors for myeloid leukemia of Down syndrome

Takashi Taga, Shiro Tanaka, Daisuke Hasegawa, Kiminori Terui, Tsutomu Toki, Shotaro Iwamoto, Hidefumi Hiramatsu, Takako Miyamura, Yoshiko Hashii, Hiroshi Moritake, Hideki Nakayama, Hiroyuki Takahashi, Akira Shimada, Tomohiko Taki, Etsuro Ito, Asahito Hama, Masafumi Ito, Katsuyoshi Koh, Daiichiro Hasegawa, Akiko M. SaitoSouichi Adachi, Daisuke Tomizawa

Research output: Contribution to journalArticlepeer-review

Abstract

Myeloid leukemia of Down syndrome (ML-DS) is associated with good response to chemotherapy, resulting in favorable outcomes. However, no universal prognostic factors have been identified to date. To clarify a subgroup with high risk of relapse, the role of minimal residual disease (MRD) was explored in the AML-D11 trial by the Japanese Pediatric Leukemia/Lymphoma Study Group. MRD was prospectively evaluated at after induction therapy and at the end of all chemotherapy, using flow cytometry (FCM-MRD) and GATA1-targeted deep sequencing (GATA1-MRD). A total of 78 patients were eligible and 76 patients were stratified to the standard risk (SR) group by morphology. In SR patients, FCM-MRD and GATA1-MRD after induction were positive in 5/65 and 7/59 patients, respectively. Three-year event-free survival (EFS) and overall survival (OS) rates were 93.3% and 95.0% in the FCM-MRD-negative population, and 60.0% and 80.0% in the positive population. Three-year EFS and OS rates were both 96.2% in the GATA1-MRD-negative population, and 57.1% and 71.4% in the positive population. Adjusted hazard ratios for associations of FCM-MRD or GATA1-MRD with EFS were 10.98 (p = 0.01) and 27.68 (p < 0.01), respectively. Detection of MRD by either FCM or GATA1 after initial induction therapy represents a significant prognostic factor for predicting ML-DS relapse.

Original languageEnglish
JournalLeukemia
DOIs
Publication statusAccepted/In press - 2021

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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