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. 2022 Dec 1;140(22):2407-2411.
doi: 10.1182/blood.2022016567.

Pretransplant FLT3-ITD MRD assessed by high-sensitivity PCR-NGS determines posttransplant clinical outcome

Sun Loo  1   2   3 , Richard Dillon  4   5 , Adam Ivey  6 , Natasha S Anstee  1   3 , Jad Othman  4   5 , Ing Soo Tiong  3   7 , Nicola Potter  5 , Jelena Jovanovic  5 , Manohursingh Runglall  5 , Chyn Chua Chong  1   3 , Ashish Bajel  2 , David Ritchie  2 , Kelli Gray  2 , Zhi Han Yeoh  2 , Michelle McBean  7 , Amanda Gilkes  8 , Ian Thomas  9 , Sean Johnson  9 , Nigel H Russell  4 , Andrew H Wei  1   2   3
Affiliations

Pretransplant FLT3-ITD MRD assessed by high-sensitivity PCR-NGS determines posttransplant clinical outcome

Sun Loo et al. Blood. .
No abstract available

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Conflict of interest statement

Conflict-of-interest disclosure: A.H.W. and N.S.A. are employees of the Walter and Eliza Hall Institute, which receives milestone and royalty payments related to venetoclax. A.H.W. has received research funding from Servier and AbbVie and is a medical advisor to Astellas, AbbVie, and Servier. The remaining authors declare no competing financial interests.

Figures

Figure 1
Figure 1.
Pre-HCTFLT3-ITD MRD and outcomes. (A) The majority of FLT3-ITD MRD detected by PCR-NGS pre-HCT is below the threshold of conventional CE. The limit of detection for FLT3-ITD as assessed by CE and PCR-NGS is indicated. Orange boxes indicate 2 patients positive for FLT3-ITD by PCR-NGS but without available CE data. (B) Relapse risk post-HCT is associated with FLT3-ITD PCR-NGS VAF ≥0.001%. Kaplan–Meier estimates of relapse-free survival according to pre-HCT FLT3-ITD MRD levels showing highest relapse risk for FLT3-ITD MRD ≥1%, lowest risk for FLT3-ITD MRD <0.001%, and intermediate risk for levels between 0.001 and <1%. (C-D) Pre-HCT FLT3-ITD MRD is associated with inferior clinical outcomes. Kaplan-Meier estimates of (C) cumulative incidence of relapse (with transplant-related mortality as a competing risk in 14 patients not included in this curve) and (D) overall survival according to pre-HCT FLT3-ITD PCR-NGS and CE status. Two patients with positive FLT3-ITD by PCR-NGS lacking CE data were excluded. (E-F) Pre-HCT FLT3-ITD and NPM1 MRD are prognostic for clinical outcome post-HCT. Kaplan-Meier estimates of (E) relapse-free and (F) overall survival according to pre-HCT FLT3-ITD PCR-NGS MRD and NPM1 MRD in 71 of 78 co-mutated for both FLT3-ITD and NPM1. Seven patients with insufficient material for NPM1 MRD assessment were excluded.
See this image and copyright information in PMC

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