Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AML
Abstract: Measurable residual disease (MRD) by multiparametric flow cytometry (MFC) before allogeneic hematopoietic cell transplantation (HCT) identifies patients at high risk of acute myeloid leukemia (AML) relapse, often occurring early after allografting. To examine the role of MFC MRD testing to...
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Elsevier
2025-02-01
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| Series: | Blood Advances |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2473952924005998 |
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| author | Naveed Ali Megan Othus Eduardo Rodríguez-Arbolí Corentin Orvain Filippo Milano Brenda M. Sandmaier Chris Davis Ryan S. Basom Frederick R. Appelbaum Roland B. Walter |
| author_facet | Naveed Ali Megan Othus Eduardo Rodríguez-Arbolí Corentin Orvain Filippo Milano Brenda M. Sandmaier Chris Davis Ryan S. Basom Frederick R. Appelbaum Roland B. Walter |
| author_sort | Naveed Ali |
| collection | DOAJ |
| description | Abstract: Measurable residual disease (MRD) by multiparametric flow cytometry (MFC) before allogeneic hematopoietic cell transplantation (HCT) identifies patients at high risk of acute myeloid leukemia (AML) relapse, often occurring early after allografting. To examine the role of MFC MRD testing to predict later relapses, we examined 935 adults with AML or myelodysplastic neoplasm/AML transplanted in first or second morphologic remission who underwent bone marrow restaging studies between day 70 and 100 after HCT and were alive and without relapse by day +100. Of 935 adults, 136 (15%) had MRD before HCT, whereas only 11 (1%) had MRD at day +70 to +100. In day +100 landmark analyses, pre-HCT and day +70 to +100 MFC MRD were both associated with relapse (both P < .001), relapse-free survival (RFS; both P < .001) overall survival (OS; both P < .001), and, for post-HCT MRD, nonrelapse mortality (P = .001) after multivariable adjustment. Importantly, although 126/136 patients (92%) with MRD before HCT tested negative for MRD at day +70 to +100, their outcomes were inferior to those without MRD before HCT and at day +70 to +100, with 3-year relapse risk of 40% vs 15% (P < .001), 3-year RFS of 50% vs 72% (P < .001), and 3-year OS of 56% vs 76% (P < .001), whereas 3-year nonrelapse mortality estimates were similar (P = .53). Thus, despite high MRD conversion rates, outcomes MRD positive/MRD negative (MRDneg) patients are inferior to those of MRDneg/MRDneg patients, suggesting all patients with pre-HCT MRD should be considered for preemptive therapies after allografting. |
| format | Article |
| id | doaj-art-b281649c92be4a3d802c8902dff0d902 |
| institution | Kabale University |
| issn | 2473-9529 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Blood Advances |
| spelling | doaj-art-b281649c92be4a3d802c8902dff0d9022025-01-31T05:12:09ZengElsevierBlood Advances2473-95292025-02-0193558570Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AMLNaveed Ali0Megan Othus1Eduardo Rodríguez-Arbolí2Corentin Orvain3Filippo Milano4Brenda M. Sandmaier5Chris Davis6Ryan S. Basom7Frederick R. Appelbaum8Roland B. Walter9Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA; Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WAPublic Health Science Division, Fred Hutchinson Cancer Center, Seattle, WATranslational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA; Department of Hematology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, University of Seville, Seville, SpainTranslational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA; Service des Maladies du Sang, Centre Hospitalier Universitaire d'Angers, Angers, France; Fédération Hospitalière-Universitaire Grand Ouest Against Leukemia (FHU-GOAL), Angers, France; Université d'Angers, INSERM Unité Mixte de Recherche (UMR) 1307, Centre National de la Recherche Scientifique (CNRS) UMR 6075, Nantes Université, Centre de Recherche en Cancérologie et Immunologie intégrée de Nantes-Angers (CRCI2NA), Angers, FranceDivision of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WADivision of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WAClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WAClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WAClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA; Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WADivision of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA; Correspondence: Roland B. Walter, Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, D1-100, Seattle, WA 98109-1024;Abstract: Measurable residual disease (MRD) by multiparametric flow cytometry (MFC) before allogeneic hematopoietic cell transplantation (HCT) identifies patients at high risk of acute myeloid leukemia (AML) relapse, often occurring early after allografting. To examine the role of MFC MRD testing to predict later relapses, we examined 935 adults with AML or myelodysplastic neoplasm/AML transplanted in first or second morphologic remission who underwent bone marrow restaging studies between day 70 and 100 after HCT and were alive and without relapse by day +100. Of 935 adults, 136 (15%) had MRD before HCT, whereas only 11 (1%) had MRD at day +70 to +100. In day +100 landmark analyses, pre-HCT and day +70 to +100 MFC MRD were both associated with relapse (both P < .001), relapse-free survival (RFS; both P < .001) overall survival (OS; both P < .001), and, for post-HCT MRD, nonrelapse mortality (P = .001) after multivariable adjustment. Importantly, although 126/136 patients (92%) with MRD before HCT tested negative for MRD at day +70 to +100, their outcomes were inferior to those without MRD before HCT and at day +70 to +100, with 3-year relapse risk of 40% vs 15% (P < .001), 3-year RFS of 50% vs 72% (P < .001), and 3-year OS of 56% vs 76% (P < .001), whereas 3-year nonrelapse mortality estimates were similar (P = .53). Thus, despite high MRD conversion rates, outcomes MRD positive/MRD negative (MRDneg) patients are inferior to those of MRDneg/MRDneg patients, suggesting all patients with pre-HCT MRD should be considered for preemptive therapies after allografting.http://www.sciencedirect.com/science/article/pii/S2473952924005998 |
| spellingShingle | Naveed Ali Megan Othus Eduardo Rodríguez-Arbolí Corentin Orvain Filippo Milano Brenda M. Sandmaier Chris Davis Ryan S. Basom Frederick R. Appelbaum Roland B. Walter Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AML Blood Advances |
| title | Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AML |
| title_full | Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AML |
| title_fullStr | Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AML |
| title_full_unstemmed | Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AML |
| title_short | Measurable residual disease as predictor of post–day +100 relapses after allografting in adult AML |
| title_sort | measurable residual disease as predictor of post day 100 relapses after allografting in adult aml |
| url | http://www.sciencedirect.com/science/article/pii/S2473952924005998 |
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