TY - JOUR
T1 - Effect of circulating blasts at time of complete remission on subsequent relapse-free survival time in newly diagnosed AML
AU - Estey, Elihu H.
AU - Thall, Peter F.
AU - Wang, Xuemei
AU - Verstovsek, Srdan
AU - Cortes, Jorge
AU - Kantarjian, Hagop M.
PY - 2003/11/1
Y1 - 2003/11/1
N2 - Standardized criteria for complete remission (CR) in acute myeloblastic leukemia (AML) require the absence of peripheral blood blasts (PBBs). However, MD Anderson (MDA) criteria for CR (CR-MDA), although including the other requirements for CR, have not included the PBB count. We exploit this difference to assess the effect of PBBs at the time of CR-MDA on relapse-free survival (RFS) time. Eighty percent of the 533 patients with newly diagnosed AML or refractory anemia with excess of blasts (RAEB) entering CR-MDA from 1995 to 2000 had no PBBs at time of CR-MDA. Ninety-three percent of the remaining patients, who thus had CR-MDA but not standard CR, had 1% to 5% PBBs at this time. Multivariate analyses, using both conventional and Bayesian approaches, indicated that PBBs had no effect on RFS. For all patients and for the subgroups given and not given granulocyte colony-stimulating factor (G-CSF), the 95% credible interval for the relative risk of failure in the PBB group was nearly centered at 1.0. Thus, our data do not support use of PBBs in defining CR in newly diagnosed AML.
AB - Standardized criteria for complete remission (CR) in acute myeloblastic leukemia (AML) require the absence of peripheral blood blasts (PBBs). However, MD Anderson (MDA) criteria for CR (CR-MDA), although including the other requirements for CR, have not included the PBB count. We exploit this difference to assess the effect of PBBs at the time of CR-MDA on relapse-free survival (RFS) time. Eighty percent of the 533 patients with newly diagnosed AML or refractory anemia with excess of blasts (RAEB) entering CR-MDA from 1995 to 2000 had no PBBs at time of CR-MDA. Ninety-three percent of the remaining patients, who thus had CR-MDA but not standard CR, had 1% to 5% PBBs at this time. Multivariate analyses, using both conventional and Bayesian approaches, indicated that PBBs had no effect on RFS. For all patients and for the subgroups given and not given granulocyte colony-stimulating factor (G-CSF), the 95% credible interval for the relative risk of failure in the PBB group was nearly centered at 1.0. Thus, our data do not support use of PBBs in defining CR in newly diagnosed AML.
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U2 - 10.1182/blood-2003-04-1309
DO - 10.1182/blood-2003-04-1309
M3 - Article
C2 - 12842982
AN - SCOPUS:0142214653
SN - 0006-4971
VL - 102
SP - 3097
EP - 3099
JO - Blood
JF - Blood
IS - 9
ER -