The presence of measurable residual disease (MRD) after induction chemotherapy is a significant prognostic marker for increased relapse risk and reduced survival in acute myeloid leukemia (AML) patients. Monitoring MRD levels can help stratify risk and assess treatment response. Two recent studies presented at the 61st American Society of Hematology (ASH) Meeting & Exposition in December 2019 explored MRD's predictive capability for relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Risk-Adapted Post-Remission Treatment in Spanish AML12 Trial
Jorge Sierra from Hospital Santa Creu Sant Pau presented the final results of the Spanish Cetlam Group's AML12 trial. This prospective study aimed to evaluate the feasibility and outcomes of risk-adapted treatment based on AML genetics at diagnosis and MRD presence after consolidation chemotherapy. The trial enrolled 812 adults across 15 Spanish academic hospitals. All patients received induction chemotherapy consisting of idarubicin plus cytarabine. Consolidation treatment involved high-dose cytarabine (HDAC), with the number of courses varying based on genetic risk: two courses for those with European LeukemiaNet (ELN)-favorable genetics and one course for those with ELN-intermediate or -adverse genetics. Subsequent therapy was determined by genetic and MRD risk analysis.
