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What is the optimal prognostic threshold for MFC MRD positivity in patients with AML?

By Haimanti Mandal

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Roland WalterRoland Walter

Jun 28, 2024

Learning objective: After reading this article, learners will be able to cite a new clinical development in the treatment of acute myeloid leukemia.


During the 2024 Transplantation & Cellular Therapy Meetings of ASTCT and CIMBTR, the AML Hub was pleased to speak with Roland Walter, Fred Hutchinson Cancer Research Center, Seattle, US. We asked, What is the optimal prognostic threshold for multiparameter flow cytometric (MFC) minimal residual disease (MRD) positivity in patients with acute myeloid leukemia (AML)? 

What is the optimal prognostic threshold for MFC MRD positivity in patients with AML?

Walter starts by highlighting the importance of MFC in detecting MRD in AML, which predicts worse outcomes in patients who are MRD positive compared with those who are MRD negative.  

He then shares insights from his research in collaboration with GIMEMA, HOVON, and MRC/NCRI, looking at the potential for suboptimal discrimination of relapse risk with the current European LeukemiaNet MRD Working Group MRD cut-off of 0.1%. Walter emphasizes that a ‘one-size-fits-all’ approach may not be ideal for accurately assessing relapse risks and suggests that centralized MRD testing can help to establish optimal thresholds for prospective trials.