Measurable residual disease testing for personalized treatment of acute myeloid leukemia

Ehinger, Mats; Pettersson, Louise

doi:10.1111/apm.12926

Cited by 12 publications

(6 citation statements)

References 121 publications

(340 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Quantitative PCR–based monitoring of MRD allows the sensitive detection of leukemia‐specific RUNX1‐RUNX1T1 or CBFB‐MYH11 transcripts and is more often used for decision algorithms . Yin et al reported that MRD monitoring after induction and consolidation chemotherapy by RT‐PCR in CBF AML allows risk stratification, and more importantly, sequential monitoring during follow‐up can accurately predict relapse.…”

Section: Discussionmentioning

confidence: 99%

Significance of minimal residual disease monitoring by real‐time quantitative polymerase chain reaction in core binding factor acute myeloid leukemia for transplantation outcomes

Yalniz

Patel

Bashir

et al. 2020

Cancer

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Significance of minimal residual disease monitoring by real‐time quantitative polymerase chain reaction in core binding factor acute myeloid leukemia for transplantation outcomes

Yalniz

Patel

Bashir

et al. 2020

Cancer

View full text Add to dashboard Cite

show abstract

“…It is applicable for monitoring a variety of NPM1 mutations [49], as well as DNMT3A and IDH mutations [50] in AML at the time of CR with the possibility to monitor several mutations simultaneously. The major disadvantage highlighted by the experts is that very often some new assays have to be designed for each patient, since a single assay needs to be developed for specific base changes in the same gene [44,51].…”

Section: The Role Of Mrd In Hsct For Amlmentioning

confidence: 99%

The Role of Measurable Residual Disease (MRD) in Hematopoietic Stem Cell Transplantation for Hematological Malignancies Focusing on Acute Leukemia

Czyż

Nagler

2019

IJMS

View full text Add to dashboard Cite

The significance of measurable residual disease (MRD) in hematopoietic stem cell transplantation (HSCT) is well recognized in different hematological malignancies, but the evidence indicate that pre-transplant MRD status is of particular importance in acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). In ALL, inadequate response at the level of MRD is a commonly accepted risk factor for relapse and thus an indication for allogeneic HSCT. Similarly, growing evidence from the literature strongly suggest that MRD detected by multiparameter flow cytometry or molecular techniques should be also used for risk stratification in AML at the time of HSCT. Despite the well-defined association of MRD and outcomes of HSCT in acute leukemias, there are still many open issues such as the role of additional pre-transplant consolidation for MRD eradication, the ability of HSCT to overcome negative influence of MRD positivity on survival, the impact of conditioning regimen intensity on MRD clearance post HSCT, and transplantation outcomes or the selection of optimal donor with regards to MRD status. In addition, the role of MRD assessment in guiding post-transplant maintenance treatment should also be addressed in prospective trials. These open issues mostly awaiting further clinical studies will be discussed in our current review.

show abstract

“…MRD has been used as surrogate parameter for treatment effectiveness in follicular lymphoma and MCL [61,62,[88][89][90][91] and further studies are needed to demonstrate the clinical utility of MRD as a biomarker for personalization of HL consolidation strategies. Despite the paucity of evidence supporting routine use of MRD assessment as part of consolidation, the marked PFS benefit seen at 4 months in the AETHERA study, with continued benefit seen over the 5year follow-up period [17,65] supports the rationale for extended use of consolidation therapy; in the case of the AETHERA study for up to 1 year after ASCT, to minimize the risk of relapse.…”

Section: Discussionmentioning

confidence: 99%

Improving outcomes after autologous transplantation in relapsed/refractory Hodgkin lymphoma: a European expert perspective

et al. 2020

View full text Add to dashboard Cite

Autologous stem cell transplantation (ASCT) is a well-established approach to treatment of patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL) recommended by both the European Society for Medical Oncology and the National Comprehensive Cancer Network based on the results from randomized controlled studies. However, a considerable number of patients who receive ASCT will progress/relapse and display suboptimal post-transplant outcomes. Over recent years, a number of different strategies have been assessed to improve post-ASCT outcomes and augment HL cure rates. These include use of pre- and post-ASCT salvage therapies and post-ASCT consolidative therapy, with the greatest benefits demonstrated by targeted therapies, such as brentuximab vedotin. However, adoption of these new approaches has been inconsistent across different centers and regions. In this article, we provide a European perspective on the available treatment options and likely future developments in the salvage and consolidation settings, with the aim to improve management of patients with HL who have a high risk of post-ASCT failure. Conclusions We conclude that early intervention with post-ASCT consolidation improves outcomes in patients with R/R HL who require ASCT. Future approvals of targeted agents are expected to further improve outcomes and provide additional treatment options in the coming age of personalized medicine.

show abstract

Measurable residual disease testing for personalized treatment of acute myeloid leukemia

Cited by 12 publications

References 121 publications

Significance of minimal residual disease monitoring by real‐time quantitative polymerase chain reaction in core binding factor acute myeloid leukemia for transplantation outcomes

Significance of minimal residual disease monitoring by real‐time quantitative polymerase chain reaction in core binding factor acute myeloid leukemia for transplantation outcomes

The Role of Measurable Residual Disease (MRD) in Hematopoietic Stem Cell Transplantation for Hematological Malignancies Focusing on Acute Leukemia

Improving outcomes after autologous transplantation in relapsed/refractory Hodgkin lymphoma: a European expert perspective

Contact Info

Product

Resources

About