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EBMT 2021 | Value of MRD in patients with NPM1-mutated AML

Farhad Ravandi, MD, University of Texas MD Anderson Cancer Center, Houston, TX, discusses the assessment of measurable residual disease (MRD) in the management of hematological malignancies. Dr Ravandi outlines data from a study investigating NPM1-mutated acute myeloid leukemia (AML), which observed that persistence of NMP1-mutated clones after two cycles of chemotherapy is highly associated with a higher risk of relapse and adverse outcomes. Dr Ravandi also describes how flow cytometry and molecular analysis can be combined to improve the assessment of MRD-negativity. This interview took place during the 47th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2021.

Transcript (edited for clarity)

Assessing minimal or measurable residual disease is continuing to become an important strategy in the management of patients with various hematological malignancies, including acute lymphoblastic and acute myeloblastic, acute myeloid leukemia. And of course there are different assays, including flow cytometry, as well as molecular analysis.

So, for example, in the case of NPM1 mutated AML this has been shown that persistence of NPM1 clones after two cycles of chemotherapy is highly associated with a higher risk of relapse and adverse outcome...

Assessing minimal or measurable residual disease is continuing to become an important strategy in the management of patients with various hematological malignancies, including acute lymphoblastic and acute myeloblastic, acute myeloid leukemia. And of course there are different assays, including flow cytometry, as well as molecular analysis.

So, for example, in the case of NPM1 mutated AML this has been shown that persistence of NPM1 clones after two cycles of chemotherapy is highly associated with a higher risk of relapse and adverse outcome.

Of course, I believe that we can actually combine these strategies, both flow cytometry and molecular analysis, to increase the predictability of an MRD-negative state. It has been shown, in some studies, that if you have two assays that are negative, this is likely to be more associated with a lower risk of relapse, as opposed to if both assays are positive or at least one of the assays are positive. So, I think perhaps the future will really depend, to at least some degree, on the combination of these strategies to assess for persistent MRD.

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