Bone marrow biopsy during induction chemotherapy for acute myeloid leukaemia identifies only 50% of patients with resistant disease

Roberts, Melanie; Juttner, Christopher A.; To, Luen Bik; Kimber, R.J.

doi:10.1016/0145-2126(88)90035-5

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…In many studies no further therapy is given on day 14, and treatment decisions for post-remission therapy are based entirely on whether or not a CR was achieved at the end of a single cycle. The actual presence of residual leukemia on day 14, or earlier, or the delayed clearance of blasts from the peripheral blood, has been reported to be predictive for a worse prognosis in several publications 13–15,18,27–29,33–35 .…”

Section: Discussionmentioning

confidence: 99%

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Rowe

Kim

Cassileth

et al. 2010

Cancer

101

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Background Patients with newly diagnosed acute myeloid leukemia (AML) often have residual leukemia in the bone marrow on day 10–14 after the start of induction therapy. Some cooperative groups administer a second cycle of similar induction therapy on day 14 if there is residual leukemia. It is common perception that the presence of residual leukemia at that point predicts for a worse prognosis, irrespective of therapy given. The purpose of this study was to determine if patients who require a second cycle of induction to achieve complete remission (CR), given on or about day 14, have a worse prognosis than patients who achieve CR after only one cycle, since a worse prognosis might alter postremission therapy. Methods Patients registered to 6 consecutive studies for AML conducted by the Eastern Cooperative Oncology Group (ECOG) between 1983 to 1993 were treated with induction therapy. If the day 14 bone marrow had residual leukemia, patients were to receive a second cycle of identical induction therapy. All patients who achieved CR after one or two cycles, received the identical post-remission therapy. Results In each of the 6 studies the long-term outcome was similar for patients requiring one or two cycles of induction to achieve CR and this was independent of other prognostic variables such as age or karyotype. In conclusion The presence of residual leukemia in a day 10–14 bone marrow does not predict for a worse prognosis if a second similar cycle of induction therapy is administered and CR is achieved.

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Section: Discussionmentioning

confidence: 99%

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Rowe

Kim

Cassileth

et al. 2010

Cancer

101

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“…Serial Tl measurements may prove to be clinically useful (32) with a reduction in the number of necessary control biopsies (26) for leukemic patients in relation to induction of remission, or as control during remission. The MR methods may further give information about possible relapse in regions of the bone marrow inaccessible for biopsy.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of the Bone Marrow in Patients with Acute Leukemia during and after Chemotherapy Changes in T1 Relaxation

Jensen

Sørensen

Thomsen³

et al. 1990

Acta Radiol

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Twenty-seven patients with acute leukemia were examined at the time of diagnosis with MR imaging and in vivo T1 relaxation time measurements of the hemopoietic bone marrow. A 1.5 T whole body magnetic resonance scanner was used. Twenty of the patients had follow-up examinations in relation to chemotherapy. Bone marrow biopsies from the posterior iliac crest were obtained within a short time interval of all MR examinations. At the time of diagnosis, TI relaxation times were increased significantly in all the leukemic patients, compared with 24 age-matched controls. A decrease in TI relaxation time towards or into the normal range was observed in 10 patients who obtained remission. The TI relaxation time remained prolonged in 6 patients who failed to obtain remission during chemotherapy. Four patients, who obtained remission with concomitant decrease of TI values towards or into the normal range, also showed prolongation ofTI relaxation time in relation to leukemic relapse. The results indicate that changes observed in TI relaxation times of the hemopoietic bone marrow in patients with acute leukemia reflect changes in disease activity, and, that serial measurements of TI values may provide clinically useful information with the possibility for identification of residual disease in regions inaccessible for biopsy.

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“…However, doubt has been raised about the value of early marrow studies in AML. In one study, a bone marrow examination at day 6 of induction chemotherapy identified only 50% of AML patients with resistant disease and falsely included 13% of patients who achieved remission (144). In another study, routine bone marrow evaluation at day 14 was found to provide useful information only in patients with circulating leukemia cells or the presence of an unexpectedly high absolute number of nonlymphocytic cells (145).…”

Section: Residual Bone Marrow Diseasementioning

confidence: 97%

Hematologic aspects of myeloablative therapy and bone marrow transplantation

Riley

Idowu

Chesney

et al. 2005

Clinical Laboratory Analysis

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The transplantation of bone marrow cells or isolated hematopoietic stem cells from the bone marrow or peripheral blood is a widely utilized form of therapy for patients with incurable diseases of the hematopoietic and immune systems. Successful engraftment of the transplanted stem cells in an adequately prepared recipient normally leads to bone marrow reconstitution over a period of several weeks, accompanied by more gradual reconstitution of the immune system. Since the recipient is profoundly ill during the initial treatment period, laboratory data is critical for monitoring engraftment, detecting residual/recurrent disease, and identifying problems that may delay bone marrow reconstitution or lead to other medical complications. Accurate blood cell counts are imperative, and most bone marrow transplantation patients undergo periodic monitoring with bone marrow aspirates and biopsies with cytogenetic, molecular, and multiparametric flow cytometric studies. The potential complications of bone marrow transplantation include engraftment failure and delayed engraftment, infection, residual bone marrow disease, acute and chronic graft versus host disease, myelofibrosis, therapy-related acute leukemia, post-transplant lympho-proliferative disorders, and toxic myelopathy.

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Bone marrow biopsy during induction chemotherapy for acute myeloid leukaemia identifies only 50% of patients with resistant disease

Cited by 15 publications

References 7 publications

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Adult patients with acute myeloid leukemia who achieve complete remission after 1 or 2 cycles of induction have a similar prognosis

Magnetic Resonance Imaging of the Bone Marrow in Patients with Acute Leukemia during and after Chemotherapy Changes in T1 Relaxation

Hematologic aspects of myeloablative therapy and bone marrow transplantation

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