These results demonstrate a strong relationship between pre-transplant minimal residual disease and post-transplant relapse and survival. <0.1% for cumulative incidence of relapse). <0.1% for overall survival, and 22.1% vs. <0.1% for leukemia-free survival, 67.8% vs. There was more heterogeneity among studies using flow cytometry-based than WT1 polymerase chain reaction-based detection (I 2=75.1% vs. Adverse cytogenetics was not an independent risk factor for death or relapse. These associations held regardless of detection method, conditioning intensity, and patient age. Pre-transplant minimal residual disease was associated with worse leukemia-free survival (hazard ratio=2.76 ), overall survival (hazard ratio=2.36 ), and cumulative incidence of relapse (hazard ratio=3.65 ), but not non-relapse mortality (hazard ratio=1.12 ). We identified 19 articles published between January 2005 and June 2016 and extracted hazard ratios for leukemia-free survival, overall survival, and cumulative incidences of relapse and non-relapse mortality. We performed a systematic review and meta-analysis evaluating the prognostic role of minimal residual disease detected by polymerase chain reaction or multiparametric flow cytometry before transplant. Minimal residual disease prior to allogeneic hematopoietic cell transplantation has been associated with increased risk of relapse and death in patients with acute myeloid leukemia, but detection methodologies and results vary widely.
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