Measurable residual disease monitoring provides insufficient lead-time to prevent morphological relapse in the majority of patients with core-binding factor acute myeloid leukemia

• Published in: Haematologica (Roma) 2021-01, Vol.106 (1), p.56-63
• Main Authors: Puckrin, Robert, Atenafu, Eshetu G., Claudio, Jaime O., Chan, Steven, Gupta, Vikas, Maze, Dawn, McNamara, Caroline, Murphy, Tracy, Schuh, Andre C., Yee, Karen, Sibai, Hassan, Minden, Mark D., Wei, Cuihong, Stockley, Tracy, Kamel-Reid, Suzanne, Schimmer, Aaron D.
• Format: Article
• Language: English
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.2019.235721

Core-binding factor acute myeloid leukemia is characterized by t(8;21) or inv(16) and the fusion proteins RUNX1-RUNX1T1 and CBFB-MYH11. International guidelines recommend monitoring for measurable residual disease every 3 months for 2 years after treatment. However, it is not known whether serial molecular monitoring can predict and prevent morphological relapse. We conducted a retrospective singlecenter study of 114 patients in complete remission who underwent molecular monitoring with real-time quantitative polymerase chain reaction analysis of RUNX1-RUNX1T1 or CBFB-MYH11 transcripts every 3 months. Morphological relapse was defined as re-emergence of >5% blasts and molecular relapse as ≥1 log increase in transcript level between two samples. Over a median follow-up time of 3.7 years (range, 0.2-14.3), remission persisted in 71 (62.3%) patients but 43 (37.7%) developed molecular or morphological relapse. Patients who achieved