An error-corrected next-generation sequencing (NGS)-based molecular measurable residual disease (MRD) assessment in patients with acute myeloid leukemia (AML) is highly predictive of relapse and survival outcomes when tested in complete remission (CR) before allogeneic hematopoietic cell transplantation (HCT).
That’s according to researchers who evaluated the clinical significance of the approach. Their study included 96 patients with AML who had an evaluable MRD marker with a variate allele frequency of ≤5% at CR prior to undergoing allogeneic HCT. Median follow-up was 6.2 years with 95% of patients undergoing transplant in CR1.
A competing risk analysis revealed a cumulative incidence of relapse (CIR) was higher in MRD positive than negative patients (hazard ratio [HR] 5.58, p<0.001, 5-year CIR 66% vs 17%), while non-relapse mortality was not significantly different (HR 0.60, p=0.47).
When compared to MRD assessment with multi-parametric flow cytometry, error-corrected NGS-based MRD analysis is more easily standardized. It could be more routinely used by practitioners to make treatment decisions for the majority of AML patients with at least one other mutation in addition to NPM1 or DNMT3A.
The researchers concluded, “NGS-based MRD is widely applicable to AML patients, highly predictive of relapse and survival, and may help refining transplant and post-transplant management in AML patients.”