Assessment of Minimal Residual Disease in Acute Myeloid Leukemia patient in Adult Egyptian Acute myeloid Leukemia Patients

Abstract

Background The term minimal residual disease (MRD) is used to describe residual disease after suboptimal induction chemotherapy, but at the same time refers to the lowest levels of disease potentially compatible with cure or to molecularly defined relapse after long term remission. This study assesses the minimal residual disease in relation to the outcome in acute myeloid leukemia patients after 6 months of treatment of chemotherapy. Aim of the work The aim of this study is assessment of measurable minimal residual disease after treatment to identify acute myeloid leukemia patients who are at high risk of poor outcome. Patients and methods Minimal Residual Disease was measured using Flow cytometry in 30 newly diagnosed a 30 newly diagnosed acute myeloid leukemia (AML) patients. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from May 2017 to November 2018. Results A total number of 30 acute myeloid leukemia patients were recruited from Ain Shams University hospital, hematology and Oncology Unit outpatient clinic, with age ranging from 18-60 years old (median age 40 years), 14 of them were males representing 46.6% of the total number and 16 were females representing 53.3% of the total number. There was no statistical significance between the age of the studied group and the MRD with P-value 0.147, the sex of the patients doesn’t contribute to the risk stratification with a P-value of 0.200. The number of cases with negative MRD after induction was 13 representing 43.3% of the total number, and was 12 patients after 6 months representing 70.5% of the remitted patients, considering that the cut out value of MRD is 0.1. There was a significant relationship between TLC and MRD, the higher the TLC the more positive the MRD. Positive MRD is associated with higher mortality rates, exhibiting a statistical significance with P-value of 0.005. Conclusion We concluded that assessment of minimal residual disease in AML is of great value in determination of prognosis of the disease and its outcome and it is of great value to determine the levels of minimal residual disease (MRD) during the course of therapy and to stratify patient to identify high risk patient and to plan the therapeutic program accordingly.