scholarly journals Detection of measurable residual disease in adults with acute leukaemia

2020 ◽  
Vol 65 (4) ◽  
pp. 460-472
Author(s):  
I. V. Galtseva ◽  
Y. O. Davydova ◽  
E. N. Parovichnikova
Keyword(s):  
Acute Leukaemia ◽  
Residual Disease ◽  
Prognostic Indicator ◽  
Residual Tumour ◽  
Treatment Protocols ◽  
Therapy Choice ◽  
Check Points ◽  
Residual Amount ◽  
Haematological Remission ◽  
Measurable Residual Disease

Introduction. Measurable residual disease (MRD) is a residual amount of malignant cells able to invoke relapse after complete haematological remission.Aim. Analysis of the MRD prognostic value in various treatment protocols for acute leukaemia.Main findings. MRD is a good prognostic indicator in lymphoblastic and myeloid leukaemia. Quantification of residual tumour cells is used for patient risk stratification according to the relapse prognosis. Stratification data, including MRD estimates at check points, may impact therapy choice, such as transplantation of allogeneic haematopoietic stem cells. Therefore, MRD estimation in acute leukaemia has become mandatory in clinical trial and research.

scholarly journals Minimal/measurable residual disease in AML: a consensus document from the European LeukemiaNet MRD Working Party

Blood ◽  
2018 ◽  
Vol 131 (12) ◽  
pp. 1275-1291 ◽  
Author(s):  
Gerrit J. Schuurhuis ◽  
Michael Heuser ◽  
Sylvie Freeman ◽  
Marie-Christine Béné ◽  
Francesco Buccisano ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Medicine ◽  
Residual Disease ◽  
Working Party ◽  
Prognostic Indicator ◽  
The United States ◽  
Molecular Data ◽  
Multiparameter Flow Cytometry ◽  
Consensus Document ◽  
Measurable Residual Disease

Abstract Measurable residual disease (MRD; previously termed minimal residual disease) is an independent, postdiagnosis, prognostic indicator in acute myeloid leukemia (AML) that is important for risk stratification and treatment planning, in conjunction with other well-established clinical, cytogenetic, and molecular data assessed at diagnosis. MRD can be evaluated using a variety of multiparameter flow cytometry and molecular protocols, but, to date, these approaches have not been qualitatively or quantitatively standardized, making their use in clinical practice challenging. The objective of this work was to identify key clinical and scientific issues in the measurement and application of MRD in AML, to achieve consensus on these issues, and to provide guidelines for the current and future use of MRD in clinical practice. The work was accomplished over 2 years, during 4 meetings by a specially designated MRD Working Party of the European LeukemiaNet. The group included 24 faculty with expertise in AML hematopathology, molecular diagnostics, clinical trials, and clinical medicine, from 19 institutions in Europe and the United States.

scholarly journals Oral azacitidine prolongs survival of patients with AML in remission independent of measurable residual disease status

Blood ◽  
2022 ◽  
Author(s):  
Gail J. Roboz ◽  
Farhad Ravandi ◽  
Andrew H. Wei ◽  
Hervé Dombret ◽  
Felicitas Thol ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Residual Disease ◽  
Disease Status ◽  
Prognostic Indicator ◽  
Leukemic Cells ◽  
Multiparameter Flow Cytometry ◽  
Intensive Chemotherapy ◽  
Hematopoietic Stem ◽  
Serial Samples ◽  
Measurable Residual Disease

Measurable residual disease (MRD) in patients with acute myeloid leukemia (AML) in remission after intensive chemotherapy is predictive of early relapse and poor survival. Post-remission maintenance therapy that prolongs MRD negativity or converts MRD positive (MRD+) patients to MRD negative (MRD-) status may delay or prevent relapse and improve overall survival (OS). In the phase 3 QUAZAR AML-001 trial, oral azacitidine (Oral-AZA; formerly CC-486), a hypomethylating agent, significantly prolonged OS and relapse-free survival (RFS) compared with placebo in patients aged ≥55 years with AML in first remission after intensive chemotherapy who were not candidates for hematopoietic stem cell transplantation. In this trial, MRD (≥0.1% leukemic cells in bone marrow) was assessed by multiparameter flow cytometry in serial samples collected at baseline and on day 1 of every 3 cycles. As expected, baseline MRD status was significantly associated with both OS and RFS. Multivariate analyses showed Oral-AZA significantly improved OS and RFS vs. placebo independent of baseline MRD status. Oral-AZA treatment also extended the duration of MRD negativity by 6 months vs. placebo, and resulted in a higher rate of conversion from MRD+ at baseline to MRD- during treatment: 37% vs. 19%, respectively. In the Oral-AZA arm, 24% of MRD responders achieved MRD negativity >6 months after treatment initiation. While presence or absence of MRD was a strong prognostic indicator of OS and RFS, there were added survival benefits with Oral-AZA maintenance therapy compared with placebo, independent of patients' MRD status at baseline. NCT01757535 Clinicaltrials.gov

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