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- Title
Interferon‐α Is Effective for Treatment of Minimal Residual Disease in Patients with t(8;21) Acute Myeloid Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation: Results of a Prospective Registry Study.
- Authors
Mo, Xiao‐Dong; Wang, Yu; Zhang, Xiao‐Hui; Xu, Lan‐Ping; Yan, Chen‐Hua; Chen, Huan; Chen, Yu‐Hong; Qin, Ya‐Zhen; Liu, Kai‐Yan; Huang, Xiao‐Jun
- Abstract
Background: RUNX1‐RUNX1T1 transcript levels were established as a powerful marker for predicting relapse in patients with t(8;21) acute myeloid leukemia (AML). We aimed to identify the efficacy of minimal residual disease (MRD)‐directed interferon‐alpha (IFN‐α) treatment in patients with t(8;21) AML who were positive for MRD after allogeneic hematopoietic stem cell transplantation (allo‐HSCT; n=42). Subjects, Materials, and Methods: MRD‐positive status was defined as a <4.5‐log reduction from diagnosis in RUNX1‐RUNX1T1 transcripts and/or the loss of a ≥4.5‐log reduction after 3 months after HSCT. Patients with positive MRD received six cycles of IFN‐α treatment (twice or thrice weekly of every 4 weeks cycle). Results: The 1‐year cumulative incidence of severe acute and chronic graft‐versus‐host disease after MRD‐directed IFN‐α treatment was 7.1% and 4.8%, respectively. After the treatment, 15 (35.7%), 5 (11.9%), 3 (7.1%), and 9 (21.5%) patients achieved MRD negativity at 1, 2, 3, and >3 months, respectively. Three patients relapsed after the IFN‐α treatment, in which the 1‐year cumulative incidence of relapse was 7.2%. One patient died of severe infection at 460 days after treatment. The 1‐year probabilities of event‐free survival, disease‐free survival, and overall survival after treatment were 76.0%, 92.4%, and 92.5%, respectively. The clinical outcomes in patients who received MRD‐directed IFN‐α treatment were significantly better than those of the MRD‐positive patients without any interventions in the historical cohort. Conclusion: MRD‐directed IFN‐α treatment is effective for patients with t(8;21) AML who were MRD‐positive after allo‐HSCT. The study was registered at http://clinicaltrials.gov as NCT02027064. Implications for Practice: In patients with t(8;21) acute myeloid leukemia (AML), the presence of post‐allogeneic hematopoietic stem cell transplantation (allo‐HSCT) minimal residual disease (MRD), measured by RUNX1‐RUNX1T1 transcript levels, has been established as a powerful marker for predicting relapse. Interferon‐alpha (IFN‐α) could exert a relatively strong graft‐versus‐leukemia effect, and MRD‐directed IFN‐α treatment is effective for patients with t(8;21) AML who were MRD‐positive after allo‐HSCT. RUNX1‐RUNX1T1 transcript levels are markers for predicting relapse in patients with t(8;21) acute myeloid leukemia (AML). This article reports the efficacy of minimal residual disease‐directed interferon‐alpha (IFN‐α) treatment in patients with t(8;21) AML who were positive for minimal residual disease after allogeneic hematopoietic stem cell transplantation.
- Subjects
THERAPEUTIC use of interferons; ACUTE myeloid leukemia diagnosis; CARCINOGENESIS; CANCER relapse; HEALTH status indicators; HEMATOPOIETIC stem cell transplantation; HOMOGRAFTS; INTERFERONS; LONGITUDINAL method; POSTOPERATIVE period; PROBABILITY theory; SURVIVAL; TRANSCRIPTION factors; DISABILITIES; ACUTE myeloid leukemia; TREATMENT effectiveness; DISEASE incidence; PROGNOSIS
- Publication
Oncologist, 2018, Vol 23, Issue 11, p1349
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2017-0692