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How Does Minimal Residual Disease Impact Clinical Outcomes in Acute Leukemias?

By: Julia Fiederlein
Posted: Thursday, October 22, 2020

Persistence of minimal residual disease detected before allogeneic hematopoietic stem cell transplantation (HSCT) seems to be associated with worsened clinical outcomes in patients with acute leukemias, according to Zoya V. Konova, MD, of the National Research Center for Hematology, Moscow, and colleagues. This study's results were presented during the virtual edition of the 2020 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract AML-180). 

“Minimal residual disease is a strong prognostic marker of increased risk of relapse and influences overall and relapse-free survival in patients with acute leukemia,” the investigators commented. “Minimal residual disease testing before allogeneic HSCT may help to identify a subgroup of acute leukemia patients at high risk of relapse who might benefit from posttransplant preemptive treatment.”

The study enrolled 84 patients with acute myeloid leukemia (AML) and 46 patients with acute lymphocytic leukemia (ALL) in their first or second morphologic remission who underwent allogeneic HSCT. Using six-color multiparameter flow cytometry, the investigators analyzed bone marrow samples obtained prior to transplant to determine minimal residual disease status.

A total of 27.4% and 23.9% of patients with AML and ALL, respectively, were identified as minimal residual disease–positive. The cumulative incidence of relapse was higher in those with minimal residual disease–positive AML than in those with minimal residual disease–negative AML (50.6% vs. 10%; P < .0001). The cumulative incidences of relapse were 76.6% in those with minimal residual disease–positive ALL and 11.6% in those with minimal residual disease–negative ALL (P = .0023). Patients with minimal residual disease–positive AML (44.3% vs. 74.4%; P < .0001) and ALL (20% vs. 72%; P = .0325) both seemed to experience significantly lower relapse-free survival rates than their minimal residual disease–negative counterparts; additionally, patients with minimal residual disease–positive AML appeared to experience decreased overall survival rates (58.6% vs. 79.7%; P = .0185).

Disclosure: No information regarding conflicts of interest was provided.



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