Cancer · 2025
Prognostic value of Day 14 measurable residual disease in acute myeloid leukemia treated with venetoclax and azacitidine.
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Lian Jiaying, Zhuang Xianxu, Chen Ying, Lin Qingqing, Pei Renzhi, Chen Dong, Li Shuangyue, Ye Peipei, Cao Junjie, Yuan Jiaojiao, Shi Xiaowei, Liu Xuhui, Lu Ying
Аннотация
BACKGROUND: Venetoclax (VEN) in combination with azacitidine (AZA) (VEN-AZA) is used to treat acute myeloid leukemia (AML) in patients who are not candidates for intensive chemotherapy but research on prognostic factors remains limited.
METHODS: Measurable residual disease (MRD) by multiparametric flow cytometry in AML is important but there is limited evidence of the clinical utility of monitoring MRD in patients treated with VEN-AZA. Herein, a total of 75 patients newly diagnosed with AML treated with VEN-AZA were retrospectively analyzed to examine the role and timing of MRD to predict survival. MRD enabled the categorization of patients into two groups: Day 14 MRD, >1% (MRD14-pos); and Day 14 MRD, ≤1% (MRD14-neg).
RESULTS: Of the 75 patients, 31 (41.3%) had MRD14-neg, whereas 30 (40.0%) had not achieved complete remission (CR) after induction. MRD14-neg was associated with improved overall survival (OS) (p = .024) and event-free survival (EFS) (p = .044). In addition, MRD14-neg (p = .002 for both OS and EFS), CSF3R negative (CSF3Rneg) (p < .001 for both OS and EFS), and transplantation (p = .005 for OS; p = .007 for EFS) were associated with improved survival outcomes. Further subgroup analysis revealed that MRD14-pos patients who underwent transplantation showed a trend toward longer OS and EFS (p < .001 for both).
CONCLUSIONS: Results in the MRD14-neg group were better than in the MRD14-pos group, and the prognosis for patients with AML was better when there was CSF3Rneg and transplantation. Additionally, for patients with AML with MRD14-pos, consolidation with transplantation may increase survival.
METHODS: Measurable residual disease (MRD) by multiparametric flow cytometry in AML is important but there is limited evidence of the clinical utility of monitoring MRD in patients treated with VEN-AZA. Herein, a total of 75 patients newly diagnosed with AML treated with VEN-AZA were retrospectively analyzed to examine the role and timing of MRD to predict survival. MRD enabled the categorization of patients into two groups: Day 14 MRD, >1% (MRD14-pos); and Day 14 MRD, ≤1% (MRD14-neg).
RESULTS: Of the 75 patients, 31 (41.3%) had MRD14-neg, whereas 30 (40.0%) had not achieved complete remission (CR) after induction. MRD14-neg was associated with improved overall survival (OS) (p = .024) and event-free survival (EFS) (p = .044). In addition, MRD14-neg (p = .002 for both OS and EFS), CSF3R negative (CSF3Rneg) (p < .001 for both OS and EFS), and transplantation (p = .005 for OS; p = .007 for EFS) were associated with improved survival outcomes. Further subgroup analysis revealed that MRD14-pos patients who underwent transplantation showed a trend toward longer OS and EFS (p < .001 for both).
CONCLUSIONS: Results in the MRD14-neg group were better than in the MRD14-pos group, and the prognosis for patients with AML was better when there was CSF3Rneg and transplantation. Additionally, for patients with AML with MRD14-pos, consolidation with transplantation may increase survival.