Application Of Multiparameter Flow Cytometry In Acute Myeloid Leukemia Treatment Effect Assessment

The therapeutic effect of acute myeloid leukemia(AML) is closely related to its response to induction chemotherapy. By detecting the responses of AML patients to induction chemotherapy, we can gain an insight into the prognosis and adjust chemotherapy regimens accordingly so as to improve the treatment effect. In this study we determined the absolute counts of blasts in PB on the 0, 3rd, 5th, 7th and 9th days of induction therapy by multiparameter flow cytometry(MFC) in 48 newly diagnosed AML(non-M3) patients. Clearance rates were calculated, and the related prognostic significance was analyzed. We revealed that the PB clearance rate on the 5th day of induction was significantly different between early CR and NCR, MRD(+) and MRD(-) groups(P=0.027, 0.002). We chose this time point to further distinguish the patients, and set the blasts clearance rate of 2.42 as a cut-off value, and statistcs showed that those whose clearance rate was below 2.42 had a higher relapse rate within 6 months(P = 0.025).In this study we also evaluated the prognostic value of MFC to detect AML-MRD in 114 AML patients, finding that after induction therapy, the relapse-free survival(RFS) and overall survival(OS) of MRD(-) group were significantly higher than that of MRD(+) group(P = 0.014、0.014). More than half of the patients(58.8%)who has moderate prognosis in cytogenetic-molecular biology, the RFS and OS of MRD(-) group were also significantly higher than that of MRD(+) group(P=0.012、0.028). Our findings also showed that the dynamic MRD changes、the time points of MRD turning negative as well as the further stratification of the MRD level after induction all have a good correlation with prognosis.