Measurable residual disease conversion rate with consolidation chemotherapy in acute myeloid leukemia

Abstract

The rate of MRD clearance in AML with standard consolidation chemotherapy is not well defined. A multi-institution retrospective analysis was performed on 107 consecutively treated AML patients in morphologic complete remission with detectable MRD post-induction therapy who received standard chemotherapy consolidation. In response to standard intermediate/high-dose cytarabine consolidation therapy, 26 of 60 patients (43.3%) with MRD threshold of detection of at least 0.1% converted to MRD-negative status (undetectable with assay used), and 6 of 47 patients (12.8%) with MRD threshold of detection > 0.1% converted to MRD-negative status. Multivariable logistic regression for patients with MRD threshold of detection of at least 0.1% showed that, when controlling for age, ELN risk category, dose of cytarabine, and use of a combination agent, treatment with 1 cycle of consolidation cytarabine versus ≥2 cycles decreased the odds of conversion of AML to MRD-negative (OR = 0.24, 95% CI 0.07–0.85, p = 0.03).

Keywords:

• Acute myeloid leukemia
• measurable residual disease
• consolidation chemotherapy
• allogeneic hematopoietic stem cell transplantation

Acknowledgments

The authors thank Dr. Jeffrey Gornbein for statistical consultation.

Disclosure statement

C.O has research funding from Stemline, AstraZeneca, Novartis, and Orca Bio. A.S. has research support from BMS; speaker and ad board for Sanofi. A.P. has research funding from Pfizer and Kronos Bio; received honoraria from BMS and AbbVie. D.J. has research funding from Jazz and Pfizer. G.M. has consultancy from Abbvie, Agios, Macrogenics, Pfizer; scientific Advisory Committees Abbvie, Agios, Astellas, BMS/Celgene, Forty Seven, Genentech, Stemline; research Funding: BMS/Celgene, Glycomimetics, Forty Seven/Gilead, Jazz, Astex, Syndax, Immune Onc, Immunogen. A.C.L. has research funding from Amgen, Astellas, Autolus, Kadmon, Kite, Pharmacyclics, Talaris; consulting for Amgen, Abbvie, Actinium, Brisol-Myers Squibb, Pfizer, Sanofi, Takeda. B.A.J has served as a consultant/advisor for AbbVie, BMS, Daiichi Sankyo, Genentech, Gilead, GlycoMimetics, Jazz, Kymera, Pfizer, Rigel, Servier, and Takeda; protocol steering committee for GlycoMimetics; data monitoring committee for Gilead; travel reimbursement/support from AbbVie and Rigel; institutional research funding from AbbVie, Amgen, Aptose, AROG, BMS, Celgene, Daiichi Sankyo, F. Hoffmann-La Roche, Forma, Forty-Seven, Genentech/Roche, Gilead, GlycoMimetics, Hanmi, Immune-Onc, Incyte, Jazz, Loxo Oncology, Pfizer, Pharmacyclics, Sigma Tau, and Treadwell. G.S. has grants from AbbVie, Actinium, Actuate, Agios, Arog, Astellas,Amgen Aptevo, AltruBio, AVM Bio, BMS/Celgene, Biopath, BioMea, Biosight, Cellularity, Celator, Constellation, Cogent, Cellectis, Daiichi-Sankyo, Deciphera, Delta-Fly, Fate, Forma, FujiFilm, Gamida, Genentech-Roche, Glycomimetics, Geron, Gilead, Incyte, Karyopharm, Kiadis, Kite/Gilead, Kronos Bio, Kura, Janssen, Immunogene, Loxo, Marker, Mateon, Onconova, Pfizer, PrECOG, Regimmune, Samus, Sangamo, Sellas, Stemline, Syros, Takeda, Tolero, Trovagene, Agios, Amgen, Jazz, Orca, Ono-UK, Novartis; consultant to BMS, Curios and Daiichi; received honoraria from AstraZeneca; board/advisory committee member for Agios, Gamida, Gilead, Incyte, Amgen, BMS, Novartis, Ono Pharma, AVM Biotech, GSK and AZ; holds stock in Amgen, BMS, and Janssen/J&J.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

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The author(s) reported there is no funding associated with the work featured in this article.