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Measurable residual disease (MRD) status before allogeneic hematopoietic cell transplantation impact on secondary acute myeloid leukemia outcome. A Study from the Acute Leukemia Working Party (ALWP) of the European society for Blood and Marrow Transplantation (EBMT)

Bone Marrow Transplantation volume 57, pages 1556–1563 (2022)Cite this article

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Abstract

Measurable residual disease (MRD) assessment before allogeneic hematopoietic cell transplantation (HCT) may help physicians to identify a subgroup of patients at high risk of relapse for de novo acute myeloid leukemia (AML) but its relevance among patients affected by secondary AML (sAML) is still unknown. We assessed the impact of MRD among 318 adult patients with sAML who received an allogeneic HCT in first complete remission. At the time of HCT, a total of 208 (65%) patients achieved MRD negativity, while 110 (35%) had positive MRD. 2-year overall survival (OS) was 58.8 % (95% CI 52.2–64.9) with leukemia-free survival (LFS) of 50.0 % (95% CI 43.7–56.1), relapse incidence of 34.2% (95% CI 28.4–40.1) and non-relapse mortality (NRM) of 23.3 % (95% CI 19–27.7) for the entire cohort. In multivariate analysis, HCT recipients with KPS ≥ 90 experienced less disease recurrence (HR 0.61, 95% CI 0.4–0.94) with better LFS (HR 0.63, 95% CI 0.44–0.89) and OS (HR 0.58, 95% CI 0.39–0.86). There were no differences in major clinical endpoints between patients with MRD-positive and MRD-negative status at the time of HCT. Pre-transplantation assessment of MRD was not informative on post-HCT outcomes in this retrospective registry-based analysis among patients affected by sAML.

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Fig. 1: Transplantation outcomes after allogeneic transplantation for measurable residual disease-positive and negative patients.
Fig. 2: GVHD-free/relapse-free survival after transplantation.

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Published data are available on specific request via email to the corresponding author.

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Authors and Affiliations

  1. IRCCS Azienda Ospedaliero-Universitaria di Bologna; Istituto “L. e A. Seràgnoli”, Bologna, Italy

    Enrico Maffini

  2. EBMT Paris Study Office, Department of Hematology and Cell Therapy, Hôpital Saint-Antoine, Paris, France

    Myriam Labopin, Arnon Nagler & Mohamad Mohty

  3. West German Cancer Center, University Hospital of Essen, Essen, Germany

    Dietrich Wilhelm Beelen

  4. University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Nicolaus Kroeger

  5. Sisli Florence Nightingale Hospital, Istanbul, Turkey

    Mutlu Arat

  6. Hematology, University of Wales, Cardiff, UK

    Keith M. O. Wilson

  7. Centre Jaen Perrin, Clermont-Ferrand, France

    Jacques-Olivier Bay

  8. Medizinische Hochschule Hannover, Hannover, Germany

    Arnold Ganser

  9. Medizinische Klinik II: Hämatologie und Onkologie, Goethe Universitat, Frankfurt am Main, Germany

    Hans Martin

  10. Division of Hematology, University Hospital Basel, Basel, Switzerland

    Jakob Passweg

  11. University College London Hospital NHS FT, London, United Kingdom

    Panagiotis D. Kottaridis

  12. CHU de Lille, UNIV Lille, INSERM U1286, Infinite, 59000, Lille, France

    Ibrahim Yakoub-Agha

  13. Instituto Catalá de Oncología Hospitalet, Barcelona, Barcelona, Spain

    Rocio Parody Porras

  14. Department of Hematology, Medical Oncology and Pneumology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany

    Eva Maria Wagner

  15. Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain

    Jordi Esteve

  16. Hematology Unit, Transplant Network, Ravenna, Italy

    Francesco Lanza

  17. Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Arnon Nagler

  18. Department of Hematology, Hospital Saint Antoine, Paris, France

    Mohamad Mohty

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  1. Enrico Maffini
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EM analyzed the data and wrote the manuscript; ML contributed to the statistical analysis. AN, JE, and MM critically appraised the paper. All the Authors approved the final version of the manuscript.

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Correspondence to Enrico Maffini.

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Maffini, E., Labopin, M., Beelen, D.W. et al. Measurable residual disease (MRD) status before allogeneic hematopoietic cell transplantation impact on secondary acute myeloid leukemia outcome. A Study from the Acute Leukemia Working Party (ALWP) of the European society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 57, 1556–1563 (2022). https://doi.org/10.1038/s41409-022-01748-w

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