Is MRD Status Predictive of Survival in Resistant AML?
Posted: Wednesday, March 10, 2021
Muhammad Umair Mushtaq, MD, of the University of Kansas Hospital–Westwood Cancer Center, Lexington, and colleagues investigated the impact of measurable residual disease (MRD) in patients with relapsed or refractory acute myeloid leukemia (AML) who underwent hematopoietic cell transplantation (HCT). Their findings concluded that negative measurable residual disease status before transplantation is a notable predictor for improved survival and was presented during the 2021 Transplantation & Cellular Therapy Meetings (TCT; Abstract 139).
The researchers focused on 54 adult patients with resistant or refractory AML who underwent HCT after salvage chemotherapy. MRD negativity was defined by the absence of leukemic cells by morphology and eight-color flow cytometry.
The median age of patients was 60, and 50% were male. Nearly 25% of patients had AML with recurrent genetic abnormalities, 19% had myelodysplasia-related changes, 11% had a therapy-related disease, and 46% had nonspecified AML. Most patients (52%) had poor AML risk status. Of those who responded to salvage chemotherapy before HCT, 50% had a negative MRD complete response, 15% had a positive MRD complete response, and 35% had refractory disease.
At a median follow-up of 23.5 months, the overall survival rate was 50%. The rate of MRD-negative complete response was 74%, the rate of MRD-positive complete response was 50%, and the rate of refractory disease was 16%. The median overall survival was 43.3 months, but patients with refractory disease had the lowest overall survival of 8.7 months.
Myeloablative conditioning was performed in 67% of participants. An adjusted multivariate model predicted that patients with negative MRD and peripheral blood stem cell donations would have better overall survival, but those with poor-risk AML would have worse overall survival. Myeloablative conditioning improved overall survival, but it did not reach statistical significance.
Disclosure: For full disclosures of study authors, visit tct.confex.com.