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- Title
CD34+CD38−CD123+ Leukemic Stem Cell Frequency Predicts Outcome in Older Acute Myeloid Leukemia Patients Treated by Intensive Chemotherapy but Not Hypomethylating Agents.
- Authors
Vergez, François; Nicolau-Travers, Marie-Laure; Bertoli, Sarah; Rieu, Jean-Baptiste; Tavitian, Suzanne; Bories, Pierre; Luquet, Isabelle; De Mas, Véronique; Largeaud, Laetitia; Sarry, Audrey; Huguet, Françoise; Delabesse, Eric; Bérard, Emilie; Récher, Christian
- Abstract
The prognostic impact of immunophenotypic CD34+CD38−CD123+ leukemic stem cell (iLSC) frequency at diagnosis has been demonstrated in younger patients treated by intensive chemotherapy, however, this is less clear in older patients. Furthermore, the impact of iLSC in patients treated by hypomethylating agents is unknown. In this single-center study, we prospectively assessed the CD34+CD38−CD123+ iLSC frequency at diagnosis in acute myeloid leukemia (AML) patients aged 60 years or older. In a cohort of 444 patients, the median percentage of iLSC at diagnosis was 4.3%. Significant differences were found between treatment groups with a lower median in the intensive chemotherapy group (0.6%) compared to hypomethylating agents (8.0%) or supportive care (11.1%) (p <0.0001). In the intensive chemotherapy group, the median overall survival was 34.5 months in patients with iLSC ≤0.10% and 14.6 months in patients with >0.10% (p = 0.031). In the multivariate analyses of this group, iLSC frequency was significantly and independently associated with the incidence of relapse, event-free, relapse-free, and overall survival. However, iLSC frequency had no prognostic impact on patients treated by hypomethylating agents. Thus, the iLSC frequency at diagnosis is an independent prognostic factor in older acute myeloid patients treated by intensive chemotherapy but not hypomethylating agents.
- Subjects
ACUTE myeloid leukemia diagnosis; CANCER chemotherapy; CANCER patients; IMMUNOPHENOTYPING; MULTIVARIATE analysis; STEM cells; SURVIVAL; ACUTE myeloid leukemia; DESCRIPTIVE statistics; OLD age
- Publication
Cancers, 2020, Vol 12, Issue 5, p1174
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers12051174