Gui Gege, Ravindra Niveditha, Hegde Pranay S, Andrew Georgia, Mukherjee Devdeep, Wong Zoë, Auletta Jeffery J, El Chaer Firas, Chen Evan C, Chen Yi-Bin, Corner Adam, Devine Steven M, Iyer Sunil G, Jimenez Jimenez Antonio Martin, De Lima Marcos J G, Litzow Mark R, Kebriaei Partow, Saber Wael, Spellman Stephen R, Zeger Scott L, Page Kristin M, Dillon Laura W, Hourigan Christopher S
Fralin Biomedical Research Institute, Virginia Tech FBRI Cancer Research Center, Washington, DC, USA.
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Bone Marrow Transplant. 2025 Feb;60(2):154-160. doi: 10.1038/s41409-024-02447-4. Epub 2024 Nov 6.
Measurable residual disease (MRD) in adults with acute myeloid leukemia (AML) in complete remission is an important prognostic marker, but detection methodology requires optimization. Persistence of mutated NPM1 or FLT3-ITD in the blood of adult patients with AML in first complete remission (CR1) prior to allogeneic hematopoietic cell transplant (alloHCT) associates with increased relapse and death after transplant. The prognostic implications of persistence of other common AML-associated mutations, such as IDH1, at this treatment landmark however remain incompletely defined. We performed testing for residual IDH1 variants (IDH1m) in pre-transplant CR1 blood of 148 adult patients undergoing alloHCT for IDH1-mutated AML at a CIBMTR reporting site between 2013 and 2019. No statistically significant post-transplant differences were observed between those testing IDH1m positive (n = 53, 36%) and negative pre-transplant (overall survival (OS): p = 0.4; relapse: p = 0.5). For patients with IDH1 mutated AML co-mutated with NPM1 and/or FLT3-ITD, only detection of persistent mutated NPM1 and/or FLT3-ITD was associated with significantly higher rates of relapse (p = 0.01). These data, from the largest study to date, do not support the detection of IDH1 mutation in CR1 blood prior to alloHCT as evidence of AML MRD for increased post-transplant relapse risk.
成人急性髓系白血病(AML)完全缓解期的可测量残留病(MRD)是一个重要的预后标志物,但检测方法需要优化。在异基因造血细胞移植(alloHCT)前,首次完全缓解(CR1)的成年AML患者血液中持续存在突变的NPM1或FLT3-ITD与移植后复发和死亡风险增加相关。然而,在这一治疗节点,其他常见的AML相关突变(如IDH1)持续存在的预后意义仍未完全明确。我们对2013年至2019年间在一个CIBMTR报告点接受alloHCT治疗的148例IDH1突变型AML成年患者移植前CR1期血液中的残留IDH1变异体(IDH1m)进行了检测。移植前IDH1m检测呈阳性(n = 53,36%)和阴性的患者之间,未观察到移植后有统计学意义的差异(总生存期(OS):p = 0.4;复发:p = 0.5)。对于IDH1突变型AML合并NPM1和/或FLT3-ITD突变的患者,只有持续检测到突变的NPM1和/或FLT3-ITD与显著更高的复发率相关(p = 0.01)。这项来自迄今为止最大规模研究的数据不支持将alloHCT前CR1期血液中IDH1突变的检测作为AML-MRD的证据,以证明移植后复发风险增加。
Bone Marrow Transplant. 2025-2
Bone Marrow Transplant. 2025-2
Bone Marrow Transplant. 2025-2
Bone Marrow Transplant. 2025-2