Article |
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
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
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.