Pretransplantation risk factors for MRD after allogeneic stem cell transplantation in AML patients: A prospective study

Author:

Chang Ying-Jun1ORCID,Li Si-Qi1,Yu Chunzi2,Xu Lan-Ping1ORCID,Wang Yu3ORCID,Zhang Xiao-hui1ORCID,Chen Huan4,Chen Yuhong1,Wang Fengr-Rong5,Sun Yuqian6ORCID,Yan Chen-Hua7,Lv Meng8,Mo Xiao-Dong1ORCID,Liu Yanrong5,Liu Kaiyan5,Zhao Xiaosu9ORCID,Zhao Xiang-Yu1,Huang Xiaojun10ORCID

Affiliation:

1. Peking University People's Hospital

2. Peking University People's Hospital,Peking University Institute of Hematology

3. Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Tr

4. Department of Hematology,People's Hospital

5. Peking University Institute of Hematology, People's hospital

6. Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease

7. Peking University People's Hosital, Peking University Institute of Hematology

8. Peking University People's Hospital, Peking University Institute of Hematology

9. Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplan

10. Peking University People's Hospital, Peking University Institute of Hematology,Peking-Tsinghua Center for Life Sciences, State Key Laboratory of Natural and Biomimetic Drugs

Abstract

Abstract

We aimed to explore the risk factors for measurable residual disease (MRD) positivity after allogeneic stem cell transplantation (allo-SCT) in AML patients. A total of 478 AML patients receiving allo-SCT were prospectively enrolled. The cumulative incidences of post-SCT MRD positivity at 100 days, 360 days and 3 years were 4.6%, 12.1% and 18.3%, respectively. Positive pre-SCT MRD was a risk factor for post-SCT MRD positivity at both 360 days and 3 years (P < 0.001). European LeukemiaNet (ELN) 2022 and 2017 risk stratification was a risk factor for positive post-SCT MRD at 100 days and 360 days (P = 0.020 and 0.047, respectively). A scoring system for predicting post-SCT MRD positivity at 360 days was established by using pre-SCT MRD and ELN 2017 risk stratification. The cumulative incidence of positive post-SCT MRD at 3 years was 13.2%, 23.6%, and 43.9% for patients with scores of 0, 1, and 2, respectively (P < 0.001). Multivariate analysis demonstrated that the scoring system was associated with a higher cumulative incidence of post-SCT MRD positivity, leukemia relapse and inferior survival. Our data indicate that positive pre-SCT MRD status, ELN 2022 risk stratification and 2017 risk stratification are independent risk factors for positive post-SCT MRD status in AML patients.

Publisher

Research Square Platform LLC

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