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The level of residual disease based on mutant NPM1 is an independent prognostic factor for relapse and survival in AML by Nona Shayegi, Michael Kramer,

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Presentation on theme: "The level of residual disease based on mutant NPM1 is an independent prognostic factor for relapse and survival in AML by Nona Shayegi, Michael Kramer,"— Presentation transcript:

1 The level of residual disease based on mutant NPM1 is an independent prognostic factor for relapse and survival in AML by Nona Shayegi, Michael Kramer, Martin Bornhäuser, Markus Schaich, Johannes Schetelig, Uwe Platzbecker, Christoph Röllig, Caroline Heiderich, Olfert Landt, Gerhard Ehninger, and Christian Thiede Blood Volume 122(1):83-92 July 4, 2013 ©2013 by American Society of Hematology

2 CIR for different NPM1mut/ABL1 cutoffs after completion of treatment with conventional chemotherapy and autologous SCT through follow-up. CIR for different NPM1mut/ABL1 cutoffs after completion of treatment with conventional chemotherapy and autologous SCT through follow-up. CIR analyzed by Gray’s regression model was affected by increasing MRD burden. CIR was calculated for the following NPM1mut/ABL1 cutoffs: (A) 0.01%, (B) 1%, (C) 1% and FLT3-ITD status, (D) 2%, (E) 5%, and (F) 10%. Nona Shayegi et al. Blood 2013;122:83-92 ©2013 by American Society of Hematology

3 CIR for different NPM1mut/ABL1 cutoffs after allogeneic SCT beginning from the first MRD assessment post-SCT. CIR for different NPM1mut/ABL1 cutoffs after allogeneic SCT beginning from the first MRD assessment post-SCT. CIR analyzed by Gray’s regression model indicates that the probability of relapse correlates with MRD burden. CIR was investigated for the following NPM1mut/ABL1 cutoffs: (A) 0.01%, (B) 1%, (C) 2%, and (D) 10%. Nona Shayegi et al. Blood 2013;122:83-92 ©2013 by American Society of Hematology

4 OS and DFS by 1% NPM1mut/ABL1 cutoff.
OS and DFS by 1% NPM1mut/ABL1 cutoff. MRD clearance or MRD reduction ≤1% after completion of study treatment translated clinically into a better (A) DFS and (B) OS. The subgroup with >1% MRD displayed a significantly worse outcome in comparison with the negative and <1% subgroups. Note that the DFS analysis started from the time of completion of the study treatment. Nona Shayegi et al. Blood 2013;122:83-92 ©2013 by American Society of Hematology

5 DFS and OS according to MRD level after allogeneic SCT
DFS and OS according to MRD level after allogeneic SCT. After SCT both MRD >1% and >10% translated into a poor outcome with a significantly higher risk to develop relapse or die. DFS and OS according to MRD level after allogeneic SCT. After SCT both MRD >1% and >10% translated into a poor outcome with a significantly higher risk to develop relapse or die. (A-B) DFS after SCT analyzed for increasing NPM1mut/ABL1 >1% (A) and NPM1mut/ABL1 >10% (B). (C-D) OS after SCT for the corresponding subgroups. Nona Shayegi et al. Blood 2013;122:83-92 ©2013 by American Society of Hematology

6 DFS and OS by MRD level at CR1.
DFS and OS by MRD level at CR1. MRD clearance or MRD reduction ≤1% after achievement of CR after induction treatment was associated with improved (A) DFS and (B) OS. The subgroup with >1% MRD displayed a significantly worse outcome in comparison with the MRD-negative and <1% subgroups. Nona Shayegi et al. Blood 2013;122:83-92 ©2013 by American Society of Hematology

7 Assessing the limits of agreement between BM and PB from 138 samples by Bland-Altman difference plot. Assessing the limits of agreement between BM and PB from 138 samples by Bland-Altman difference plot. The differences between the two sources were plotted against their averages. The analysis revealed that assessment from PB may be 1.07% above or 2.22% below BM. UAL, upper analysis limit; LAL, lower analysis limit. Nona Shayegi et al. Blood 2013;122:83-92 ©2013 by American Society of Hematology


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