Minimal Residual Disease a Powerful Prognosticator in Standard-Risk AML

Minimal residual disease (MRD) detected by quantitation of NPM1-mutated transcripts is more predictive of relapse and survival than molecular profiling in patients with NPM1-mutated acute myeloid leukemia (AML), according to a study of 2,569 samples obtained from 346 patients with NPM1-mutated AML. Persistence of NPM1-mutated transcripts in blood was present in 15% of patients after a second chemotherapy cycle and was significantly associated with a greater risk of 3-year relapse than was an absence of such transcripts (82% vs. 30%; p<0.001) and a lower rate of survival (24% vs. 75%; p<0.001). MRD was the only independent prognostic factor for death in a multivariate analysis (hazard ratio, 4.84; 95% CI, 2.57 to 9.15; p<0.001). The researchers concluded that determining MRD by quantitation of NPM1-mutated transcripts provides “powerful prognostic information independent of other risk factors.”

Ivey A, et al. N Engl J Med

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