Analyzing the Prognostic Significance of Measurable Residual Disease Testing Before Allogeneic Transplantation in AML Patients

A study examined the clinical use of ultra-deep next-generation sequencing measurable residual disease (NGS-MRD) before allogeneic hematopoietic cell transplantation (alloHCT). The findings were presented at the 2022 American Society of Clinical Oncology Annual Meeting.

The study analyzed 448 patients aged 18 or older who underwent first-time alloHCT between 2013 and 2017 for AML with FLT3, NPM1, IDH1, IDH2, and Kit mutations at time of diagnosis. All patients had pre-conditioning remission blood samples available.

According to the results, testing positive by NGS-MRD prior to alloHCT was associated with a 3-year redefining functional status (RFS) of 36% (95% CI, 28-45%) compared with 56% (95% CI, 51-62%) in patients who tested negative testing negative (P<.001). The investigators noted that detection of NPM1 or FLT3-ITD mutations prior to alloHCT was linked with a 3-year relapse probability of 55% (43-67%) and RFS of 26% (16-37%).

“In this largest cohort of NGS-MRD testing prior to alloHCT for AML reported to date, we confirm the ability to identify patients in CR1 but at high-risk of subsequent relapse,” the researchers concluded. They added that the findings provide “the foundation for future precision medicine approaches to reduce post-transplant AML relapse.”