BACKGROUND: Despite the well-defined role of minimal residual disease (MRD) monitoring by real-time quantitative polymerase chain reaction (RT-PCR) for RUNX1/RUNX1T1 and CBFB-MYH11 transcripts in core binding factor (CBF) acute myeloid leukemia (AML) after intensive chemotherapy, there has been a paucity of data assessing the utility of MRD monitoring at and after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: Patients with CBF AML who underwent HSCT in complete remission (first or second) from January 2007 through December 2018 were included in this analysis. RESULTS: MRD by polymerase chain reaction at HSCT was assessed in 50 of 76 patients, and 44 (88%) had evidence of MRD (MRDpos). MRDpos patients had 3-year overall survival (OS) and leukemia-free survival (LFS) rates of 69.3% and 66.3%, respectively. Six MRD-negative patients had 3-year OS and LFS rates of 100% and 100%, respectively. Thirty-five of the 70 evaluable patients (50%) had a day +100 MRD assessment by RT-PCR, and 14 (40%) were MRDpos. The presence of MRD by RT-PCR on day +100 was not associated with lower estimates of LFS (75% vs 82.2%; P = .3) but was associated with a higher relapse incidence, although the difference did not reach statistical significance (27.6% vs 9.7%; P = .2). CONCLUSIONS: Durable complete remissions can be achieved in patients with CBF AML with HSCT even if they are MRDpos by RT-PCR at HSCT. The clinical impact of frequent MRD monitoring for identifying a group at high risk for early relapse and then for determining the best time point for therapeutic interventions to prevent impending relapse warrants investigation in prospectively designed clinical trials.
BACKGROUND: Despite the well-defined role of minimal residual disease (MRD) monitoring by real-time quantitative polymerase chain reaction (RT-PCR) for RUNX1/RUNX1T1 and CBFB-MYH11 transcripts in core binding factor (CBF) acute myeloid leukemia (AML) after intensive chemotherapy, there has been a paucity of data assessing the utility of MRD monitoring at and after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS:Patients with CBF AML who underwent HSCT in complete remission (first or second) from January 2007 through December 2018 were included in this analysis. RESULTS: MRD by polymerase chain reaction at HSCT was assessed in 50 of 76 patients, and 44 (88%) had evidence of MRD (MRDpos). MRDpos patients had 3-year overall survival (OS) and leukemia-free survival (LFS) rates of 69.3% and 66.3%, respectively. Six MRD-negative patients had 3-year OS and LFS rates of 100% and 100%, respectively. Thirty-five of the 70 evaluable patients (50%) had a day +100 MRD assessment by RT-PCR, and 14 (40%) were MRDpos. The presence of MRD by RT-PCR on day +100 was not associated with lower estimates of LFS (75% vs 82.2%; P = .3) but was associated with a higher relapse incidence, although the difference did not reach statistical significance (27.6% vs 9.7%; P = .2). CONCLUSIONS: Durable complete remissions can be achieved in patients with CBF AML with HSCT even if they are MRDpos by RT-PCR at HSCT. The clinical impact of frequent MRD monitoring for identifying a group at high risk for early relapse and then for determining the best time point for therapeutic interventions to prevent impending relapse warrants investigation in prospectively designed clinical trials.
Authors: Betül Oran; Kwang Woo Ahn; Caitrin Fretham; Amer Beitinjaneh; Asad Bashey; Attaphol Pawarode; Baldeep Wirk; Bart L Scott; Bipin N Savani; Christopher Bredeson; Daniel Weisdorf; David I Marks; David Rizzieri; Edward Copelan; Gerhard C Hildebrandt; Gregory A Hale; Hemant S Murthy; Hillard M Lazarus; Jan Cerny; Jane L Liesveld; Jean A Yared; Jean Yves-Cahn; Jeffrey Szer; Leo F Verdonck; Mahmoud Aljurf; Marjolein van der Poel; Mark Litzow; Matt Kalaycio; Michael R Grunwald; Miguel Angel Diaz; Mitchell Sabloff; Mohamed A Kharfan-Dabaja; Navneet S Majhail; Nosha Farhadfar; Ran Reshef; Richard F Olsson; Robert Peter Gale; Ryotaro Nakamura; Sachiko Seo; Saurabh Chhabra; Shahrukh Hashmi; Shatha Farhan; Siddhartha Ganguly; Sunita Nathan; Taiga Nishihori; Tania Jain; Vaibhav Agrawal; Ulrike Bacher; Uday Popat; Wael Saber Journal: Transplant Cell Ther Date: 2021-08-14
Authors: Alex Bataller; Ana Garrido; Francesca Guijarro; Guadalupe Oñate; Marina Diaz-Beyá; Montserrat Arnan; Mar Tormo; Susana Vives; María Paz Queipo de Llano; Rosa Coll; David Gallardo; Ferran Vall-Llovera; Lourdes Escoda; Antonio Garcia-Guiñon; Olga Salamero; Antònia Sampol; Brayan M Merchan; Joan Bargay; Sandra Castaño-Díez; Daniel Esteban; Aina Oliver-Caldés; Andrea Rivero; Pablo Mozas; Mònica López-Guerra; Marta Pratcorona; Lurdes Zamora; Dolors Costa; Maria Rozman; Josep F Nomdedéu; Dolors Colomer; Salut Brunet; Jorge Sierra; Jordi Esteve Journal: Blood Adv Date: 2022-02-22