Tracing leukemia stem cells and its influence on clinical course of adult acute myeloid leukemia

This study aimed to demonstrate the impact of LSCs on MRD induction day (14) and Day (28) on overall survival (OS) and disease free survival (DFS) as well as compare it to MRD status. 84 De novo adult AML patients tested for LSCs panels CD38/CD123/CD34/CD45, CD90/CD133/CD45/CD33 as well as different regular MRD panels. Day 14post induction, high expression of CD123% and CD133% had an adverse impact on both OS and DFS (p=0.004 & P=<0.001) (P=<0.001& P=<0.001) respectively.A higher [CD34+/CD38-/CD123+] % influence unfavorable OS and DFS (P=<0.001 & P=<0.001).Both [CD34+/CD38-/CD123+] [CD34-/CD38+/CD123+] % at d14 had adverse impact only on DFS (P<0.001, P=0.029)In multivariate analysis CD133 expression and MRD status were independent prognostic parameter (HR 2.3, p= 0.015, 95% CI:1.2- 4.4) and (HR 2.9, p= 0.041, 95% CI: 1.0-7.9).Day28: MRD+ and increased [CD123+/ CD34-], [CD34+/CD38-/CD123+], [CD133+/ CD33-]%, were associated with inferior OS (p=0.016, p=0.0035, p=.0.002 and p=.0.002 respectively). Regarding DFS: MRD+ and high levels of [CD34+CD123+], [CD133+/ CD33-], [CD34+/CD38-/CD123+], were associated with inferior DFS (p<0.001, p=0.002, p<0.001, p<0.001 respectively). In multivariate analysis, only CD133+/CD33- frequency was the only independent prognostic factor (HR 3.1, P value = 0.003, 95% CI: 1.5-6.7).Estimation of LSCs is a sensitive indicator of response of therapy in adult AML and may be better than regular MRD panels.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research