Impact of Ultra Rapid Molecular Profiling on Treatment Delays and Healthcare Utilization of Patients Hospitalized for Acute Leukemia

• Published in: Blood 2024-11, Vol.144 (Supplement 1), p.5058-5058
• Main Authors: Dhawale, Tejaswini, Nardi, Valentina, Wang, Charlotte, Bard, Adam, Essigmann, Natalia, Leonard, Daniel, Graubert, Timothy Aaron, Fathi, Amir T.
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2024-208059

Background Molecular testing is fundamental to treatment decisions in patients with acute leukemia. The impact of rapid molecular profiling on the timing of treatment initiation and healthcare utilization in patients hospitalized for suspected acute leukemia has not been described. Methods We conducted a retrospective chart review of patients hospitalized and treated for suspected acute leukemia at Massachusetts General Hospital between September 2023 and April 2024. We conducted a detailed workflow analysis comparing the time to obtaining molecular profiling results from admission [“time to results” or TTR] between routine (legacy) methods (i.e., RT-PCT, karyotype, FISH, targeted DNA and RNA sequencing) and an ultra-rapid genomic profiling test (Thermo Fisher Genexus Oncomine Myeloid Panel, or “Genexus”) which was run in parallel. We used linear regression models to evaluate the impact of TTR on time to treatment initiation from admission [TTTI] and hospital length of stay [LOS]. Results Of the 111 patients who had ultra-rapid genomic profiling conducted during the study period, 57 (51.4%) were adult patients who were hospitalized for diagnostic workup and treatment of suspected acute leukemia. The most common leukemia subtypes were acute myeloid leukemia (n=39/57, 68.4%), B-lymphoblastic leukemia (n=9/57, 15.8%), and acute promyelocytic leukemia (n=4/57, 7.0%). The mean TTTI was 5.2 days (range 1-17) and mean LOS was 30.9 days (range 3-86). Genexus had a mean TTR of 3.1 days (range 1-8), whereas legacy methods had a mean TTR of 5.4 days (range 3-10). Longer TTR was associated with longer TTTI (b=0.95; SE=0.20; P=