Minimal residual disease before HSCT influences OS, RFS in acute leukemia
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Minimal residual disease persistence prior to allogeneic hematopoietic stem cell transplant influenced OS and RFS among patients with acute leukemia, according to study results presented at Society of Hematologic Oncology Annual Meeting.
Researchers observed the association despite the occurrence of morphological complete remission prior to transplantation. Testing for minimal residual disease (MRD) might help to identify a subgroup of patients with acute leukemia who need preemptive treatment, researchers wrote.
Disease relapse is a common cause of treatment failure after allogeneic HSCT (allo-HSCT) for patients with acute leukemia. MRD identified through multiparameter flow cytometry serves as a strong prognostic marker of increased risk for relapse.
Zoya Konova, MD, of National Research Center for Hematology in Moscow, and colleagues examined the impact of MRD before allo-HSCT on clinical outcomes of 84 patients with acute myeloid leukemia and 46 patients with acute lymphoblastic leukemia, all of whom were in their first or second morphologic remission after transplantation.
Researchers performed six-color multiparameter flow cytometry on bone marrow samples before allo-HSCT. They defined MRD as a cell population deviating from the normal patterns of antigen expression on specific cell lineages at specific stages of maturation, or as a cell population carrying markers of leukemia-associated immunophenotypes at diagnosis for patients with these immunophenotypes.
The investigators used the Kaplan-Meier method to estimate OS, RFS and cumulative incidence of relapse (CIR) probabilities.
Results showed 23 patients (27.4%) with AML and 11 patients (23.9%) with ALL had MRD before transplantation.
Among patients with AML, nine with MRD positivity relapsed vs. four with MRD negativity (CIR, 50.6% vs. 10%; P < .0001). Among patients with ALL, six with MRD positivity relapsed vs. three with MRD negativity (CIR, 76.6% vs. 11.6%; P = .0023).
A statistical analysis showed significant differences in outcomes based on detection of MRD.
MRD positivity appeared associated with worse RFS probability among patients with AML (44.3% vs. 74.4%; P < .0001) and ALL (20% vs. 72%; P = .0325) and worse OS probability among patients with AML (58.6% vs. 79.7%; P = .0185).
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Konova Z, et al. Abstract AML-180. Presented at: Society of Hematologic Oncology Annual Meeting (virtual meeting); Sept. 9-12, 2020.
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