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The following is a summary of “Relative prognostic value of flow cytometric measurable residual disease before allogeneic hematopoietic cell transplantation for adults with MDS/AML or AML,” published in the February 2024 issue of Hematology by Orvain et al.

Researchers conducted a retrospective analysis to assess if multiparameter flow cytometry (MFC)-detectable minimal residual disease (MRD) prior to allogeneic hematopoietic cell transplantation (HCT) holds independent prognostic significance in myelodysplastic neoplasm/acute myeloid leukemia (MDS/AML), a newly defined disease entity, compared to its established role in predicting poor outcomes in AML.

They involved 1,265 adults with MDS/AML (151) or AML (1114) who underwent their first allograft in first or second morphologic remission (April 2006 to March 2023) to determine the correlation between disease type, pre-HCT MRD, and post-HCT outcomes.

The results showed that at the 3-year mark, with no significant differences in relapse rates (29% for MDS/AML vs 29% for AML, P=.98), relapse-free survival (RFS; 50% vs 55%, P=.22),(OS; 52% vs 60%, P=.073), and non-relapse mortality (22% vs 16%, P=.14). A notable interaction was noted between pre-HCT MFC MRD and disease type (MDS/AML vs AML) for relapse (P=.009), RFS (P=.011), and OS (P=.039). The interaction models indicated lower HRs for the association between pre-HCT MRD and post-HCT outcomes in patients with MDS/AML (for relapse: HR = 1.75 [0.97–3.15] in MDS/AML vs 4.13 [3.31–5.16] in AML; for RFS: HR = 1.58 [1.02–2.45] vs 2.98 [2.48–3.58]; for OS: HR = 1.50 [0.96–2.35] vs 2.52 [2.09–3.06]). Cytogenetic abnormalities post-HCT provided comparable insights in MDS/AML and AML cases.

Investigators concluded that Pre-HCT MFC-MRD, unlike cytogenetic testing, offered limited prognostic value in MDS/AML compared to AML patients for predicting post-transplant outcomes.

Source: onlinelibrary.wiley.com/doi/abs/10.1002/ajh.27259