Prognostic Value of Measurable Residual Disease in Patients with AML Undergoing HSCT: A Multicenter Study

Allogeneic hematopoietic stem cell transplantation (HSCT) represents the best therapeutic option for many patients with acute myeloid leukemia (AML). However, relapse remains the main cause of mortality after transplantation. The detection of measurable residual disease (MRD) by multiparameter flow...

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Published in:Cancers 2023-03, Vol.15 (5), p.1609
Main Authors: Caballero-Velázquez, Teresa, Pérez-López, Olga, Yeguas Bermejo, Ana, Rodríguez Arbolí, Eduardo, Colado Varela, Enrique, Sempere Talens, Amparo, Vidriales, María Belén, Solé-Rodríguez, María, Quirós Caso, Covadonga, Pérez López, Estefanía, Reinoso Segura, Marta, Prats-Martín, Concepción, Montesinos, Pau, Pérez-Simón, Jose A
Format: Article
Language:English
Subjects:
Acute myeloid leukemia
Bone marrow
Clinical medicine
Consortia
Flow cytometry
Genotype & phenotype
Graft versus host disease
Hematopoietic stem cells
Laboratories
Leukemia
Mortality
Patients
Prognosis
Remission
Stem cell transplantation
Transplantation
Transplants & implants
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Summary:Allogeneic hematopoietic stem cell transplantation (HSCT) represents the best therapeutic option for many patients with acute myeloid leukemia (AML). However, relapse remains the main cause of mortality after transplantation. The detection of measurable residual disease (MRD) by multiparameter flow cytometry (MFC) in AML, before and after HSCT, has been described as a powerful predictor of outcome. Nevertheless, multicenter and standardized studies are lacking. A retrospective analysis was performed, including 295 AML patients undergoing HSCT in 4 centers that worked according to recommendations from the Euroflow consortium. Among patients in complete remission (CR), MRD levels prior to transplantation significantly influenced outcomes, with overall (OS) and leukemia free survival (LFS) at 2 years of 76.7% and 67.6% for MRD-negative patients, 68.5% and 49.7% for MRD-low patients (MRD < 0.1), and 50.5% and 36.6% for MRD-high patients (MRD ≥ 0.1) ( < 0.001), respectively. MRD level did influence the outcome, irrespective of the conditioning regimen. In our patient cohort, positive MRD on day +100 after transplantation was associated with an extremely poor prognosis, with a cumulative incidence of relapse of 93.3%. In conclusion, our multicenter study confirms the prognostic value of MRD performed in accordance with standardized recommendations.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15051609