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Association Between Pretransplant Molecular MRD and Outcomes in AML

By: Anna Nowogrodzki
Posted: Friday, March 5, 2021

Pretransplant molecular measurable residual disease (MRD) seems to negatively impact outcomes, independent of European LeukemiaNet classification and conditioning intensity, in patients with acute myeloid leukemia (AML), according to a recent study. Muhammad Husnain, MD, of the University of Arizona Cancer Center, Tucson, and colleagues presented their results at the 2021 Transplantation & Cellular Therapy Meetings (Abstract 158).

“Molecular measurable residual disease is the most important prognostic factor for relapse in our cohort of AML patients receiving transplant consolidation,” the authors wrote.

The retrospective study included 120 patients with AML in complete morphologic remission. Patients received a hematopoietic stem cell transplant between 2012 and 2019. The authors sorted the patients into three risk categories based on 2017 European LeukemiaNet criteria: favorable, intermediate, and adverse. Molecular MRD was defined as persistent leukemia-specific mutations and did not include persistent DTA mutations.

The median follow-up was 2.8 years. Overall survival was significantly worse in patients who had pretransplant molecular MRD (36%) than those who did not (76%). Patients with molecular MRD also had worse 2-year relapse-free survival (40%) than those who did not (71%). The hazard ratios were 3.03 for overall survival and 2.7 for 2-year relapse-free survival.

Myeloablative conditioning (which 65% of patients received) did not affect overall survival or relapse-free survival. The authors noted that further study is important to determine whether peritransplant strategies would affect patients' survival with molecular MRD.

Disclosure: The study authors’ disclosures may be found at tct.confex.com.


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