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ASH 2024 | Studying immunophenotypic abnormalities to improve MRD assessment in subtypes of AML
In this video, Sanam Loghavi, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, comments on the challenges of detecting measurable residual disease (MRD) in certain acute myeloid leukemia (AML) subtypes, such as myelodysplasia-related and NPM1-mutated disease. Dr Loghavi notes that AML is a heterogeneous disease, and leukemia-associated mutations or abnormalities may change or disappear with treatment, making it difficult to distinguish between clonal hematopoiesis-related immunophenotypic abnormalities and true residual MRD. This study aims to characterize and describe the immunophenotypic abnormalities associated with clonal hematopoiesis, with the goal of improving the accuracy of MRD assessment in these patients. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
There are certain subtypes of acute myeloid leukemia that have molecular markers of MRD, which is considered to be a more objective and specific method for measurement of MRD. For those AMLs that we don’t have a molecular target, we’re still using flow cytometry. The problem with flow cytometry is that if you use… so the way we look for MRD is using two methods...
There are certain subtypes of acute myeloid leukemia that have molecular markers of MRD, which is considered to be a more objective and specific method for measurement of MRD. For those AMLs that we don’t have a molecular target, we’re still using flow cytometry. The problem with flow cytometry is that if you use… so the way we look for MRD is using two methods. One is leukemia-associated immunophenotypes, where you’re looking for the initial immunophenotype that was associated with the baseline AML. The other is deviation from normal, because as you know, AML is a heterogeneous disease. So you may not have the actual original phenotype that persists at MRD, and you may have different subclones, the phenotype may change a little bit with therapy. So we look for deviation from normal as well, to say that a population is abnormal. The problem with that approach is that oftentimes you’ll have the leukemia-associated mutations or abnormalities go away, and you’ll have residual clonal hematopoiesis that may also be associated with an abnormal immunophenotype. And we have a little bit of a problem telling the difference between clonal hematopoiesis-related immunophenotypic abnormalities versus something that’s truly residual MRD.
And so the focus of this study was to try and look at and characterize what we think is a mild abnormality, a deviation from normal that may not truly represent MRD, but may be associated with clonal hematopoiesis because obviously we don’t want to overcall immunophenotypic aberrancies that are associated with clonal hematopoiesis as MRD. And so to characterize those and hopefully in the big publication in the paper, one of things we’re going to focus on is really to describe the detail of the immunophenotypic abnormalities to help the community, the people in the community, to be able to do a more accurate assessment of flow cytometric measurement of MRD.
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Disclosures
Syndx, Servier, BMS: Membership on an entity’s Board of Directors or advisory committees; Astellas, Amgen: Research Funding; Abbvie: Current holder of stock options in a privately-held company; Guidepoint; QualWorld; Gerson Lehrman Group, AlphaSight, Arima, Qiagen, Opinion Health: Consultancy; Abbvie, Daiichi Sankyo, BluePrint Medicine, Caris Diagnostics, Recordati, Servier: Consultancy; Pathology Education Partners; VJ HemeOnc, College of American Pathologists, OncLive, ICCS, MD Education, NCCN, MashUp Media, NCTN, Aptitude Health: Honoraria.
