Clinical significance of minimal residual disease detected by multidimensional flow cytometry: Serial monitoring after allogeneic stem cell transplantation for acute leukemia

Pre-transplant MRD predicts outcome following reduced-intensity and myeloablative allogeneic hemopoietic SCT in AML

“…There remains a need for standardization of MFC techniques and to establish the level at which MRD becomes clinically relevant. 8,10,11,13,20,23,24,27 As expected, we identified a difference in clinical characteristics between patients who are MRD-positive and -negative pre-HSCT; 80% of patients with secondary AML remained MRD-positive and patients in the MRD-positive group were more likely to have failed induction therapy. MRD-positive patients were more heavily treated pre-transplant, having received a salvage regimen in 36/41 cases, suggesting that this group had a higher risk to develop disease than the MRD-negative cohort.…”

“…Smaller studies have suggested an association between the presence of MRD post-HSCT and relapse, 23,24 but currently there is insufficient evidence to suggest modification of post transplant management on the basis of post transplant MRD status.…”

Prognostic and therapeutic implications of minimal residual disease at the time of transplantation in acute leukemia

“…The latter may be particularly warranted in the setting of persistent or newly developed MRD after transplantation, because numerous studies have established that post-HCT MRD detected by PCR, flow cytometry, or (as a surrogate) levels of mixed chimerism accurately identifies a subset of patients at high risk for relapse and poor outcome. 16,17,[33][34][35]40,63,[66][67][68][69][70][71][72][73] As there are no data available from controlled trials addressing these questions, inferences need to be made from observational studies that compare subgroups …”

Optimal time-points for minimal residual disease monitoring change on the basis of the method used in patients with acute myeloid leukemia who underwent allogeneic stem cell transplantation: A comparison between multiparameter flow cytometry and Wilms’ tumor 1 expression

“…However, results obtained by MFC were focused on pre-transplant assessment [6][7][8] whereas results from WT1 expression were provided predominantly after transplant [10][11][12][13]. Moreover, discordant results on prognosis were obtained when MFC and WT1 levels were compared in allografts [14][15][16]. Therefore, the most predictive time points between pre-and post-transplant as well as the real sensitivity of the two methods in predicting the relapse in this setting remains a challenge.…”