TY - JOUR
T1 - Association of hematologic response and assay sensitivity on the prognostic impact of measurable residual disease in acute myeloid leukemia
T2 - a systematic review and meta-analysis
AU - Short, Nicholas J.
AU - Fu, Chenqi
AU - Berry, Donald A.
AU - Walter, Roland B.
AU - Freeman, Sylvie D.
AU - Hourigan, Christopher S.
AU - Huang, Xuelin
AU - Gonzalez, Graciela Nogueras
AU - Hwang, Hyunsoo
AU - Qi, Xinyue
AU - Kantarjian, Hagop
AU - Zhou, Shouhao
AU - Ravandi, Farhad
PY - 2022/12
Y1 - 2022/12
N2 - Measurable residual disease (MRD) is associated with relapse and survival in acute myeloid leukemia (AML). We aimed to quantify the impact of MRD on outcomes across clinical contexts, including its association with hematologic response and MRD assay sensitivity. We performed systematic literature review and meta-analysis of 48 studies that reported the association between MRD and overall survival (OS) or disease-free survival (DFS) in AML and provided information on the MRD threshold used and the hematologic response of the study population. Among studies limited to patients in complete remission (CR), the estimated 5-year OS for the MRD-negative and MRD-positive groups was 67% (95% Bayesian credible interval [CrI], 53–77%) and 31% (95% CrI, 18–44%), respectively. Achievement of an MRD-negative response was associated with superior DFS and OS, regardless of MRD threshold or analytic sensitivity. Among patients in CR, the benefit of MRD negativity was highest in studies using an MRD cutoff less than 0.1%. The beneficial impact of MRD negativity was observed across MRD assays and timing of MRD assessment. In patients with AML in morphological remission, achievement of MRD negativity is associated with superior DFS and OS, irrespective of hematologic response or the MRD threshold used.
AB - Measurable residual disease (MRD) is associated with relapse and survival in acute myeloid leukemia (AML). We aimed to quantify the impact of MRD on outcomes across clinical contexts, including its association with hematologic response and MRD assay sensitivity. We performed systematic literature review and meta-analysis of 48 studies that reported the association between MRD and overall survival (OS) or disease-free survival (DFS) in AML and provided information on the MRD threshold used and the hematologic response of the study population. Among studies limited to patients in complete remission (CR), the estimated 5-year OS for the MRD-negative and MRD-positive groups was 67% (95% Bayesian credible interval [CrI], 53–77%) and 31% (95% CrI, 18–44%), respectively. Achievement of an MRD-negative response was associated with superior DFS and OS, regardless of MRD threshold or analytic sensitivity. Among patients in CR, the benefit of MRD negativity was highest in studies using an MRD cutoff less than 0.1%. The beneficial impact of MRD negativity was observed across MRD assays and timing of MRD assessment. In patients with AML in morphological remission, achievement of MRD negativity is associated with superior DFS and OS, irrespective of hematologic response or the MRD threshold used.
UR - https://doi.org/10.1038/s41375-022-01692-0
U2 - 10.1038/s41375-022-01692-0
DO - 10.1038/s41375-022-01692-0
M3 - Article
SN - 0887-6924
VL - 36
SP - 2817
EP - 2826
JO - Leukemia
JF - Leukemia
ER -