Pre-transplant detection of measurable residual disease in pediatric AML
Overview
This study evaluates the prognostic significance of pre-transplant measurable residual disease (MRD) detected by multiparameter flow cytometry in children with acute myeloid leukemia (AML) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Background
Acute myeloid leukemia (AML) is a prevalent malignancy in children, with a significant risk of relapse even after treatment. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a critical therapeutic option, yet relapse remains a leading cause of mortality.
Data Highlights
Outcome
3-Year Rate
Disease-Free Survival (DFS)
85.5% ± 4.2%
Overall Survival (OS)
86.8% ± 4.1%
Key Findings
Pre-transplant MFC-MRD positivity is associated with inferior 3-year DFS (HR = 14.304, P = 0.010) and OS (HR = 15.847, P = 0.008).
Among relapsed patients, the majority harbored high-risk fusion genes.
The study included 80 pediatric AML patients who underwent allo-HSCT during their first complete remission.
Patients with specific high-risk fusion genes, such as NUP98 rearrangements and FUS::ERG, may be at increased risk of relapse post-transplant.
Achieving deep remission prior to transplantation is emphasized as crucial for reducing tumor burden.
Clinical Implications
The findings suggest the need for assessing pre-transplant MRD status in pediatric AML patients.
Conclusion
Pre-transplant MFC-MRD positivity is a prognostic indicator in pediatric AML patients undergoing allo-HSCT.
