At the 46 th Annual Meeting of the European Society for Blood and Marrow Transplantation, the AML Hub held a virtual Satellite Symposium on the impact of measurable residual disease (MRD) assessment on stem cell transplantation (SCT) outcome in patients with acute myeloid leukemia (AML).
The Satellite Symposium started with presentations focusing on the methodological aspects of MRD assessment. It began with Jaqueline Cloos providing an update on flow cytometry approaches, followed by Christian Thiede, who spoke about the latest advances in molecular MRD techniques. In the subsequent talks, the need for MRD assessment prior to SCT was evaluated by Adriano Venditti, while Charles Craddock highlighted the benefits of posttransplant MRD assessment for treatment decision making.
Methods to detect MRD
Multiparameter flow cytometry
After a brief overview of the techniques used to assess MRD in AML, Jacqueline Cloos focused on multiparameter flow cytometry (MFC)-based MRD measurements. MFC is one of the most commonly used assays for MRD detection, and there are two different approaches for MFC-based MRD assessment:
- The leukemia-associated immunophenotype (LAIP) approach, which identifies a patient-specific LAIP at diagnosis that can be monitored in subsequent samples.
- The different-from-normal (DfN) approach, based on the identiﬁcation of aberrant antigen expression patterns at follow-up. The DfN approach can be useful if information from diagnosis is not available, and also to detect new aberrancies. Because information from diagnosis is not available, it is not possible to assess the efficacy of a novel drug with this approach.
Jacqueline Cloos reinforced the European LeukemiaNet (ELN) Working Party guidelines, which recommend combining both methods for MFC-based MRD assessmentin a “LAIP-based DfN approach.” In addition, these guidelines suggest a cutoff to define MRD-negativity of 0.1%, and the preferential use of bone marrow samples. 1Watch Jacqueline Cloos’s presentation in the video below.