The Prognostic Value of Minimal Residual Disease Assessed During the Remission Induction Stage in Acute Myeloid Leukemia Patients
Year: 2025
Type: article
Abstract: BACKGROUND. The assessment of minimal residual disease (MRD) in acute myeloid leukemias (AML) is an important tool for predicting treatment outcomes, especially in patients with favorable and intermediate cytogenetic/molecular risk. MRD assessed by multicolor flow cytometry (MFC) allows to identify patients with high relapse risk. MRD-positive status after the second chemotherapy cycle is associated with low long-term survival rates. AIM. To assess the long-term therapy outcomes in AML patients with vs. without MRD measured during the remission induction stage. MATERIALS & METHODS. The study enrolled 73 AML patients treated at the National Research Center for Hematology from 2017 to 2021. They were aged 17 to 58 years (median 37 years); there were 45 women and 28 men. Patients were treated with the ‘ОМЛ-17’ and ‘mОМЛ-17’ regimens. MRD was measured by MFC after the first and second induction chemotherapy cycles. RESULTS. After 2 induction cycles, complete remission was achieved in 89.1 % (65/73) of patients. After the first cycle, MRD-negative status was confirmed in 66.7 % (38/57) of patients and after the second one it was documented in 74.6 % (44/59) of patients. MRD-positive status after the first and the second chemotherapy cycles was associated with the lowest rates of overall and disease-free survival as well as higher relapse risk. Multivariate analysis confirmed MRD-negative status in the period of complete remission to be a key factor in reducing the relapse risk and mortality. CONCLUSION. The present study demonstrates that MRD status at two end-points of the program AML therapy (after the first and second induction cycles) serves as an optimal basis for predicting treatment outcomes. MRD-positive status at each of these end-points is associated with a high relapse risk and worse survival. Therefore, MRD monitoring during the remission induction stage is a powerful tool for personalizing the therapy and improving the prognosis of AML patients.
Source: Clinical oncohematology
Institution: National Medical Research Center for Hematology
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411904713