Al-Badri, Waleed K. W.

Bachas, Costa

Breems, Dimitri A.

Cloos, Jacqueline

Fischer, Thomas

Gjertsen, Bjorn T.

Gradowska, Patrycja

Greuter, Marjolein J. E.

Griskevicius, Laimonas

Janssen, Jeroen J. W. M.

Juliusson, Gunnar

Loewenberg, Bob

Maertens, Johan

Manz, Markus G.

Ngai, Lok Lam

Ossenkoppele, Gert J.

Pabst, Thomas

Passweg, Jakob

Porkka, Kimmo

Tettero, Jesse M.

van Elssen, Catharina H. M. J.

van Gorkom, Gwendolyn N. Y.

Frontiers in Oncology

Finnish

PubMed

Helsingin yliopiston digitaalinen arkisto

Concordance in measurable residual disease result after first and second induction cycle in acute myeloid leukemia : An outcome- and cost-analysis

Measurable residual disease (MRD) measured using multiparameter flow-cytometry (MFC) has proven to be an important prognostic biomarker in acute myeloid leukemia (AML). In addition, MRD is increasingly used to guide consolidation treatment towards a non-allogenic stem cell transplantation treatment for MRD-negative patients in the ELN-2017 intermediate risk group. Currently, measurement of MFC-MRD in bone marrow is used for clinical decision making after 2 cycles of induction chemotherapy. However, measurement after 1 cycle has also been shown to have prognostic value, so the optimal time point remains a question of debate. We assessed the independent prognostic value of MRD results at either time point and concordance between these for 273 AML patients treated within and according to the HOVON-SAKK 92, 102, 103 and 132 trials. Cumulative incidence of relapse, event free survival and overall survival were significantly better for MRD-negative (<0.1%) patients compared to MRD-positive patients after cycle 1 and cycle 2 (p ≤ 0.002, for all comparisons). A total of 196 patients (71.8%) were MRD-negative after cycle 1, of which the vast majority remained negative after cycle 2 (180 patients; 91.8%). In contrast, of the 77 MRD-positive patients after cycle 1, only 41 patients (53.2%) remained positive. A cost reduction of –€571,751 per 100 patients could be achieved by initiating the donor search based on the MRD-result after cycle 1. This equals to a 50.7% cost reduction compared to the current care strategy in which the donor search is initiated for all patients. These results show that MRD after cycle 1 has prognostic value and is highly concordant with MRD status after cycle 2. When MRD-MFC is used to guide consolidation treatment (allo vs non-allo) in intermediate risk patients, allogeneic donor search may be postponed or omitted after cycle 1. Since the majority of MRD-negative patients remain negative after cycle 2, this could safely reduce the number of allogeneic donor searches and reduce costs

Al-Badri, Waleed K.W.

van Elssen, Catharina H.M.J.

van Gorkom, Gwendolyn N.Y.

Greuter, Marjolein J.E.

Löwenberg, Bob

Janssen, Jeroen J.W.M.

NARCIS 

Concordance in measurable residual disease result after first and second induction cycle in acute myeloid leukemia: An outcome- and cost-analysis

Measurable residual disease (MRD) measured using multiparameter flow-cytometry (MFC) has proven to be an important prognostic biomarker in acute myeloid leukemia (AML). In addition, MRD is increasingly used to guide consolidation treatment towards a non-allogenic stem cell transplantation treatment for MRD-negative patients in the ELN-2017 intermediate risk group. Currently, measurement of MFC-MRD in bone marrow is used for clinical decision making after 2 cycles of induction chemotherapy. However, measurement after 1 cycle has also been shown to have prognostic value, so the optimal time point remains a question of debate. We assessed the independent prognostic value of MRD results at either time point and concordance between these for 273 AML patients treated within and according to the HOVON-SAKK 92, 102, 103 and 132 trials. Cumulative incidence of relapse, event free survival and overall survival were significantly better for MRD-negative (<0.1%) patients compared to MRD-positive patients after cycle 1 and cycle 2 (p ≤ 0.002, for all comparisons). A total of 196 patients (71.8%) were MRD-negative after cycle 1, of which the vast majority remained negative after cycle 2 (180 patients; 91.8%). In contrast, of the 77 MRD-positive patients after cycle 1, only 41 patients (53.2%) remained positive. A cost reduction of -€571,751 per 100 patients could be achieved by initiating the donor search based on the MRD-result after cycle 1. This equals to a 50.7% cost reduction compared to the current care strategy in which the donor search is initiated for all patients. These results show that MRD after cycle 1 has prognostic value and is highly concordant with MRD status after cycle 2. When MRD-MFC is used to guide consolidation treatment (allo vs non-allo) in intermediate risk patients, allogeneic donor search may be postponed or omitted after cycle 1. Since the majority of MRD-negative patients remain negative after cycle 2, this could safely reduce the number of allogeneic donor searches and reduce costs

Tettero, Jesse M,

Al-Badri, Waleed K W,

Ngai, Lok Lam,

Bachas, Costa,

Breems, Dimitri A,

van Elssen, Catharina H M J,

Fischer, Thomas,

Gjertsen, Bjorn T,

van Gorkom, Gwendolyn N Y,

Gradowska, Patrycja,

Greuter, Marjolein J E,

Griškevičius, Laimonas,

Juliusson, Gunnar,

Maertens, Johan,

Manz, Markus G,

Pabst, Thomas,

Passweg, Jakob,

Porkka, Kimmo,

Löwenberg, Bob,

Ossenkoppele, Gert J,

Janssen, Jeroen J W M,

Cloos, Jacqueline,

Vilnius University Institutional Repository

Concordance in measurable residual disease result after first and second induction cycle in acute myeloid leukemia: An outcome- and cost-analysis /

Measurable residual disease (MRD) measured using multiparameter flow-cytometry (MFC) has proven to be an important prognostic biomarker in acute myeloid leukemia (AML). In addition, MRD is increasingly used to guide consolidation treatment towards a non-allogenic stem cell transplantation treatment for MRD-negative patients in the ELN-2017 intermediate risk group. Currently, measurement of MFC-MRD in bone marrow is used for clinical decision making after 2 cycles of induction chemotherapy. However, measurement after 1 cycle has also been shown to have prognostic value, so the optimal time point remains a question of debate. We assessed the independent prognostic value of MRD results at either time point and concordance between these for 273 AML patients treated within and according to the HOVON-SAKK 92, 102, 103 and 132 trials. Cumulative incidence of relapse, event free survival and overall survival were significantly better for MRD-negative (&lt;0.1%) patients compared to MRD-positive patients after cycle 1 and cycle 2 (p ≤ 0.002, for all comparisons). A total of 196 patients (71.8%) were MRD-negative after cycle 1, of which the vast majority remained negative after cycle 2 (180 patients; 91.8%). In contrast, of the 77 MRD-positive patients after cycle 1, only 41 patients (53.2%) remained positive. A cost reduction of –€571,751 per 100 patients could be achieved by initiating the donor search based on the MRD-result after cycle 1. This equals to a 50.7% cost reduction compared to the current care strategy in which the donor search is initiated for all patients. These results show that MRD after cycle 1 has prognostic value and is highly concordant with MRD status after cycle 2. When MRD-MFC is used to guide consolidation treatment (allo vs non-allo) in intermediate risk patients, allogeneic donor search may be postponed or omitted after cycle 1. Since the majority of MRD-negative patients remain negative after cycle 2, this could safely reduce the number of allogeneic donor searches and reduce costs.</p

EUR Research Repository

English

Concordance in measurable residual disease result after first and second induction cycle in acute myeloid leukemia:An outcome- and cost-analysis

PubMed Central

Measurable residual disease (MRD) measured using multiparameter flow-cytometry (MFC) has proven to be an important prognostic biomarker in acute myeloid leukemia (AML). In addition, MRD is increasingly used to guide consolidation treatment towards a non-allogenic stem cell transplantation treatment for MRD-negative patients in the ELN-2017 intermediate risk group. Currently, measurement of MFC-MRD in bone marrow is used for clinical decision making after 2 cycles of induction chemotherapy. However, measurement after 1 cycle has also been shown to have prognostic value, so the optimal time point remains a question of debate. We assessed the independent prognostic value of MRD results at either time point and concordance between these for 273 AML patients treated within and according to the HOVON-SAKK 92, 102, 103 and 132 trials. Cumulative incidence of relapse, event free survival and overall survival were significantly better for MRD-negative (&lt;0.1%) patients compared to MRD-positive patients after cycle 1 and cycle 2 (p &lt;= 0.002, for all comparisons). A total of 196 patients (71.8%) were MRD-negative after cycle 1, of which the vast majority remained negative after cycle 2 (180 patients; 91.8%). In contrast, of the 77 MRD-positive patients after cycle 1, only 41 patients (53.2%) remained positive. A cost reduction of -euro571,751 per 100 patients could be achieved by initiating the donor search based on the MRD-result after cycle 1. This equals to a 50.7% cost reduction compared to the current care strategy in which the donor search is initiated for all patients. These results show that MRD after cycle 1 has prognostic value and is highly concordant with MRD status after cycle 2. When MRD-MFC is used to guide consolidation treatment (allo vs non-allo) in intermediate risk patients, allogeneic donor search may be postponed or omitted after cycle 1. Since the majority of MRD-negative patients remain negative after cycle 2, this could safely reduce the number of allogeneic donor searches and reduce costs

Tettero, J.M.

Al-Badri, W.K.W.

Ngai, L.L.

Bachas, C.

Breems, D.A.

van Elssen, C.H.M.J.

Fischer, T.

Gjertsen, B.T.

van Gorkom, G.N.Y.

Gradowska, P.

Greuter, M.J.E.

Griskevicius, L.

Juliusson, G.

Maertens, J.

Manz, M.G.

Pabst, T.

Passweg, J.

Porkka, K.

Loewenberg, B.

Ossenkoppele, G.J.

Janssen, J.J.W.M.

Cloos, J.

Maastricht University Research Portal

Measurable residual disease (MRD) measured using multiparameter flow-cytometry (MFC) has proven to be an important prognostic biomarker in acute myeloid leukemia (AML). In addition, MRD is increasingly used to guide consolidation treatment towards a non-allogenic stem cell transplantation treatment for MRD-negative patients in the ELN-2017 intermediate risk group. Currently, measurement of MFC-MRD in bone marrow is used for clinical decision making after 2 cycles of induction chemotherapy. However, measurement after 1 cycle has also been shown to have prognostic value, so the optimal time point remains a question of debate. We assessed the independent prognostic value of MRD results at either time point and concordance between these for 273 AML patients treated within and according to the HOVON-SAKK 92, 102, 103 and 132 trials. Cumulative incidence of relapse, event free survival and overall survival were significantly better for MRD-negative (&amp;lt;0.1%) patients compared to MRD-positive patients after cycle 1 and cycle 2 (p ≤ 0.002, for all comparisons). A total of 196 patients (71.8%) were MRD-negative after cycle 1, of which the vast majority remained negative after cycle 2 (180 patients; 91.8%). In contrast, of the 77 MRD-positive patients after cycle 1, only 41 patients (53.2%) remained positive. A cost reduction of –€571,751 per 100 patients could be achieved by initiating the donor search based on the MRD-result after cycle 1. This equals to a 50.7% cost reduction compared to the current care strategy in which the donor search is initiated for all patients. These results show that MRD after cycle 1 has prognostic value and is highly concordant with MRD status after cycle 2. When MRD-MFC is used to guide consolidation treatment (allo vs non-allo) in intermediate risk patients, allogeneic donor search may be postponed or omitted after cycle 1. Since the majority of MRD-negative patients remain negative after cycle 2, this could safely reduce the number of allogeneic donor searches and reduce costs.</jats:p

Jesse M. Tettero

Waleed K. W. Al-Badri

Lok Lam Ngai

Costa Bachas

Dimitri A. Breems

Catharina H. M. J. van Elssen

Thomas Fischer

Bjorn T. Gjertsen

Gwendolyn N. Y. van Gorkom

Patrycja Gradowska

Marjolein J. E. Greuter

Laimonas Griskevicius

Gunnar Juliusson

Johan Maertens

Markus G. Manz

Thomas Pabst

Jakob Passweg

Kimmo Porkka

Bob Löwenberg

Gert J. Ossenkoppele

Jeroen J. W. M. Janssen

Jacqueline Cloos

Crossref

https://pure.eur.nl/ws/files/70004795/Concordance_in_measurable_residual_disease_result_after_first_and_second_induction_cycle_in_acute_myeloid_leukemia.pdf

Concordance in measurable residual disease result after first and second induction cycle in acute myeloid leukemia : An outcome- and cost-analysis

Abstract

Similar works

Full text

Available Versions

Helsingin yliopiston digitaalinen arkisto

NARCIS

Vilnius University Institutional Repository

EUR Research Repository

EUR Research Repository

EUR Research Repository

PubMed Central

Maastricht University Research Portal

NARCIS

Crossref