BMSEHA15
Published online 10 March 2010
(Haematologica 2010, 10.3324/haematol.2009.019364)
Copyright © 2010 by Ferrata Storti Foundation
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Article

Changes in MR bone marrow angiogenesis on day 7 after induction chemotherapy can predict outcome of acute myeloid leukemia

Hsin-An Hou1, Tiffany Ting-Fang Shih2, Chieh-Yu Liu3, Bang-Bin Chen2, Jih-Luh Tang1, Ming Yao1, Shang-Yi Huang1, Wen-Chien Chou4, Chao-Yu Hsu2, Hwei-Fang Tien1

1 Department of Internal Medicine, National Taiwan University Hospital and College of Medicine
2 Department of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine
3 Biostatistics Consulting Laboratory, Department of Nursing, National Taipei College of Nursing
4 Department of Laboratory Medicine, National Taiwan University Hospital and College of Medicine

Correspondence: Hwei-Fan Tien, M.D., Ph.D., No 7, Chung-Shan South Rd, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan E-mail: hftien{at}ntu.edu.tw

ABSTRACT

Background: Recently, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been shown as a non-invasive technique that provides global and functional imaging of bone marrow angiogenesis in acute myeloid leukemia (AML).

Design and Methods: To assess the clinical implication of angiogenesis change shortly after induction chemotherapy, DCE-MRI was performed prospectively before treatment (day 0) and day 7 in 80 patients with de novo AML.

Results: We demonstrated that reduction of Peak (negative {Delta}Peak) post-therapeutically, compared with the day 0 value, was significantly associated with higher chance of achieving complete remission, better overall survival and disease-free survival (p=0.022, 0.003 and 0.007, respectively). Cox multivariate analysis also identified negative {Delta}Peak value as an independent good prognostic factor for overall survival and disease-free survival.

Conclusions: Our findings provide evidence that the change of Peak on day 7 relative to pre-treatment levels may be a relevant biomarker for early identification of patients who may fail from conventional induction chemotherapy

Key words: acute myeloid leukemia, BM angiogenesis, outcome, DCE-MRI.