Post-remission measurable residual disease directs treatment choice and improves outcomes for patients with intermediate-risk acute myeloid leukemia in CR1

• Published in: International journal of hematology 2022-12, Vol.116 (6), p.892-901
• Main Authors: Han, Lijie, Li, Yilu, Wu, Jiaying, Peng, Jie, Han, Xiaolin, Zhao, Hongmian, He, Chen, Li, Yuanyuan, Wang, Weimin, Zhang, Mengmeng, Li, Yafei, Sun, Hui, Cao, Haixia, Sang, Li’na, Jiang, Zhongxing, Yu, Jifeng
• Format: Article
• Language: English
• Subjects: Acute myeloid leukemia; Chemotherapy; Flow cytometry; Hematology; Hematopoietic stem cells; Leukemia; Medical prognosis; Medicine; Medicine & Public Health; Oncology; Original; Original Article; Remission; Remission (Medicine); Risk; Stem cell transplantation; Stem cells; Survival; Transplantation
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-022-03441-6

Objectives This study retrospectively investigated in which cycle measurable residual disease (MRD) is associated with prognosis in patients in first complete remission (CR1) of intermediate-risk acute myeloid leukemia (AML). Methods The study enrolled 235 younger patients with intermediate-risk AML. MRD was evaluated by multiparameter flow cytometry after the 1st, 2nd, and 3rd chemotherapy cycles (MRD1–3, respectively). Results No significant association was detected after the 1st and 2nd cycles. However, the 5-year incidence of relapse was higher in the MRD3-positive group ( n  = 99) than in the negative group ( n  = 136) (48.7% vs. 13.7%, P  = 0.005), while 5-year disease-free survival (DFS) and overall survival (OS) were lower in the MRD3-positive group than in the negative group (43.2% vs. 81.0% and 45.4% vs. 84.1%; P  = 0.003 and 0.005, respectively). Allogeneic hematopoietic stem cell transplantation led to a lower 5-year relapse, and higher DFS and OS rates than chemotherapy in the MRD3-positive group (22.3% vs. 71.5%, 65.9% vs. 23.0%, and 67.1% vs. 23.9%; P