Hematopoietic cell transplantation as treatment of patients with acute myeloid leukemia with measurable residual disease after consolidation therapy

Appelbaum, Frederick R.

doi:10.1016/j.beha.2018.09.009

Cited by 5 publications

(1 citation statement)

References 21 publications

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“…In general, an improvement of DFS of >10% has been adopted to justify the decision towards an allogeneic HSCT [95]. As previously discussed, many studies reported higher relapse incidences and shorter survival for patients being MRD-positive prior to allogeneic HSCT—irrespective of the used MRD marker or intensity of conditioning regimens [22,27,28,29,30,40,42,44,62,71,96]. One study even showed that MFC-MRD-positive patients had outcomes comparable to patients transplanted with active AML [27].…”

Section: Clinical Implications Of Mrd Detectionmentioning

confidence: 99%

Clinical Challenges and Consequences of Measurable Residual Disease in Non-APL Acute Myeloid Leukemia

Jentzsch

Schwind

Bach

et al. 2019

Cancers

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The ability to detect residual levels of leukemic blasts (measurable residual disease, MRD) has already been integrated in the daily routine for treatment of patients with chronic myeloid and acute lymphoblastic leukemia. In acute myeloid leukemia (AML), a variety of mostly retrospective studies have shown that individuals in AML remission who tested positive for MRD at specific time-points or had increasing MRD levels are at significantly higher risk of relapse and death compared to MRD-negative patients. However, these studies differ with respect to the “MRD-target”, time-point of MRD determination, material analyzed, and method applied. How this probably very valuable MRD information in individual patients may be adapted in the daily clinical routine, e.g., to separate patients who need more aggressive therapies from those who may be spared additional—potentially toxic—therapies is still a work-in-progress. With the exception of MRD assessment in acute promyelocytic leukemia (APL), the lack of randomized, prospective trials renders MRD-based decisions and clinical implications in AML a difficult task. As of today, we still do not have proof that early intervention in MRD-positive AML patients would improve outcomes, although this is very likely. In this article, we review the current knowledge on non-APL AML MRD assessment and possible clinical consequences.

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