Acute myeloid leukemia (AML) is a blood and bone marrow cancer. The white cells grow abnormally, and they cannot get detected by standard diagnoses like the cytomorphologic analysis. The patients are subsequently assessed for measurable residual disease (MRD). It is a prognostic indicator to stratify risk and plan treatments. This study associates MRD with survival outcomes in AML patients.
The study relates MRD status to disease-free survival (DFS) in AML patients. It relies on PubMed, MEDLINE, and Embase literature to link MRD and overall survival (OS) through literature search, study screening, systematic reviews, and meta-analyses. Bayesian hierarchical modeling was done using sample size, median age, follow-up time, specimen source, AML subtype, MRD detection, and assessment time points data.
The team extracted data from 81 publications involving 11151 patients. The average hazard ratio of MRD negativity for OS and DFS were 0.36 and 0.37, respectively. The 5-year DFS estimate for patients with and without MRD was 25% and 64%, respectively. Their estimated OS was 34% and 68%.
The MRD negativity association with higher DFS and OS was significant for all subgroups. The assessments were consistent across age groups, time, AML subtypes, and specimen source. The only exception was MRD assessments with cytogenetic or in situ fluorescent hybridization. MRD status is a valuable endpoint to speed up innovative AML therapy evaluations.
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