Measurable residual disease (MRD) testing for acute leukemia in EBMT transplant centers: a survey on behalf of the ALWP of the EBMT

Abstract

Detectable measurable residual disease (MRD) is a key prognostic factor in both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) patients. Thus, we conducted a survey in EBMT transplant centers focusing on pre-and post-allo-HCT MRD. One hundred and six centers from 29 countries responded. One hundred had a formal strategy for routine MRD assessment, 91 for both ALL and AML. For ALL (n = 95), assessing MRD has been routine practice starting from 2010 (range, 1990-2019). Techniques used for MRD assessment consisted of PCR techniques alone (n = 27), multiparameter flow cytometry (MFC, n = 16), both techniques (n = 43), next-generation sequencing (NGS) + PCR (n = 2), or PCR + MFC + NGS (n = 7). The majority of centers assessed MRD every 2-3 months for 2 (range, 1-until relapse) years. For AML, assessing MRD was routine in 92 centers starting in 2010 (range 1990-2019). Assessment of MRD was by PCR (n = 23), MFC (n = 13), both PCR and MFC (n = 39), both PCR and NGS (n = 3), and by all three techniques (n = 14). The majority assesses MRD for AML every 2-3 months for 2 (range, 1-until relapse) years. This survey is the first step in the aim to include MRD status as a routine registry capture parameter in acute leukemia.

Prognostic value of measurable residual disease monitoring by next-generation sequencing before and after allogeneic hematopoietic cell transplantation in acute myeloid leukemia

“…Interestingly, we were able to schematize donor-originated clonal hematopoiesis in detail, which could be discriminated from donor cell leukemia because it appeared just after allo-HSCT and disappeared during relapse. Taken together, these data provide evidence for the validity of serial NGS-MRD monitoring after allo-HSCT, although the technique needs to be upgraded with improved sequencing methods with higher sensitivity and a minimal error rate 22 , 23 .…”

Outcome of haploidentical versus matched sibling donors in hematopoietic stem cell transplantation for adult patients with acute lymphoblastic leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

“…Data collected included recipient and donor characteristics (age, gender, cytomegalovirus (CMV) serostatus, disease characteristics, disease status at transplant, year of transplant, and type of conditioning regimen, stem cell source, and graft versus host disease (GVHD) prophylaxis regimen). Pre-transplantation MRD status and allocation to MRD-negative or MRD-positive groups were determined by individual participating centers and utilized molecular and/or immunophenotyping criteria methodology [19]. The conditioning regimen was defined as myeloablative (MAC) or reduced intensity (RIC) based on the reports from individual transplant centers as per previously established criteria [20].…”

Development and validation of a disease risk stratification system for patients with haematological malignancies: a retrospective cohort study of the European Society for Blood and Marrow Transplantation registry

“…Future versions will optimally include a more comprehensive set of molecular and cytogenetic markers and MRD, which is currently not routinely captured in registries. 20,[28][29][30] A similarly constructed system for paediatric trans plantation would also be valuable and would necessitate the inclusion of nonmalignant transplant indications. We see several applications for the DRSS.…”