Minimal Residual Disease Best Method to Define Complete Remission in AML

Results of a study of 359 adults transplanted for acute myeloid leukemia (AML) indicate there is clinical relevance to minimal residual disease (MRD) that may lead to a better estimate of expected treatment outcomes. Of the 311 adults transplanted for AML while in morphologic complete remission, 76 (24%) had positive minimal residual disease (MRD) as detected by flow cytometry, and these patients experienced outcomes similar to patients transplanted with active disease (≥ 5% blasts). Three-year relapse rates were 67% in patients in MRD-positive morphologic remission and 65% in patients with active AML, compared with 22% in patients in MRD-negative remission. Three-year overall survival in these 3 groups were 26%, 23%, and 73%, respectively. The researchers concluded that because outcomes between patients in MRD-positive morphologic remission and those with active disease at the time of HCT were comparable, treatment algorithms should use MRD-based rather than morphology-based disease assessments.

Araki D, et al. J Clin Oncol

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