Measurable residual disease by flow cytometry in acute myeloid leukemia is prognostic, independent of genomic profiling Journal Article


Authors: Ganzel, C.; Sun, Z.; Baslan, T.; Zhang, Y.; Gönen, M.; Abdel-Wahab, O. I.; Racevskis, J.; Garrett-Bakelman, F.; Lowe, S. W.; Fernandez, H. F.; Ketterling, R.; Luger, S. M.; Litzow, M.; Lazarus, H. M.; Rowe, J. M.; Tallman, M. S.; Levine, R. L.; Paietta, E.
Article Title: Measurable residual disease by flow cytometry in acute myeloid leukemia is prognostic, independent of genomic profiling
Abstract: Measurable residual disease (MRD) assessment provides a potent indicator of the efficacy of anti-leukemic therapy. It is unknown, however, whether integrating MRD with molecular profiling better identifies patients at risk of relapse. To investigate the clinical relevance of MRD in relation to a molecular-based prognostic schema, we measured MRD by flow cytometry in 189 AML patients enrolled in ECOG-ACRIN E1900 trial (NCT00049517) in morphologic complete remission (CR) (28.8 % of the original cohort) representing 44.4 % of CR patients. MRD positivity was defined as ≥ 0.1 % of leukemic bone marrow cells. Risk classification was based on standard cytogenetics, fluorescence-in-situ-hybridization, somatic gene analysis, and sparse whole genome sequencing for copy number ascertainment. At 84.6 months median follow-up of patients still alive at the time of analysis (range 47.0–120 months), multivariate analysis demonstrated that MRD status at CR (p = 0.001) and integrated molecular risk (p = 0.0004) independently predicted overall survival (OS). Among risk classes, MRD status significantly affected OS only in the favorable risk group (p = 0.002). Expression of CD25 (α-chain of the interleukin-2 receptor) by leukemic myeloblasts at diagnosis negatively affected OS independent of post-treatment MRD levels. These data suggest that integrating MRD with genetic profiling and pre-treatment CD25 expression may improve prognostication in AML. © 2022 Elsevier Ltd
Keywords: flow cytometry; minimal residual disease; cd25; acute myeloid leukemia; genomic profiling; mrd; measurable residual disease
Journal Title: Leukemia Research
Volume: 123
ISSN: 0145-2126
Publisher: Elsevier Ltd  
Date Published: 2022-12-01
Start Page: 106971
Language: English
DOI: 10.1016/j.leukres.2022.106971
PROVIDER: scopus
PMCID: PMC9789386
PUBMED: 36332294
DOI/URL:
Notes: Article -- Export Date: 1 November 2022 -- Source: Scopus
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MSK Authors
  1. Mithat Gonen
    1030 Gonen
  2. Martin Stuart Tallman
    649 Tallman
  3. Ross Levine
    778 Levine
  4. Scott W Lowe
    249 Lowe
  5. Timour Baslan
    46 Baslan
  6. Yanming Zhang
    199 Zhang