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. 2023 Dec;98(12):1847-1855.
doi: 10.1002/ajh.27087. Epub 2023 Sep 6.

Measurable residual disease monitoring in patients with acute myeloid leukemia treated with lower-intensity therapy: Roadmap from an ELN-DAVID expert panel

Farhad Ravandi  1 , Jacqueline Cloos  2 , Francesco Buccisano  3 , Richard Dillon  4 , Konstanze Döhner  5 , Sylvie D Freeman  6 , Christopher S Hourigan  7 , Gerrit J Ossenkoppele  2 , Gail J Roboz  8 , Marion Subklewe  9 , Christian Thiede  10 , Isabell Arnhardt  11 , Peter J M Valk  12 , Adriano Venditti  3 , Andrew H Wei  13 , Roland B Walter  14 , Michael Heuser  11
Affiliations

Measurable residual disease monitoring in patients with acute myeloid leukemia treated with lower-intensity therapy: Roadmap from an ELN-DAVID expert panel

Farhad Ravandi et al. Am J Hematol. 2023 Dec.

Abstract

With the availability of effective targeted agents, significant changes have occurred in the management of patients with acute myeloid leukemia (AML) over the past several years, particularly for those considered unfit for intensive chemotherapy. While testing for measurable residual disease (MRD) is now routinely performed in patients treated with intensive chemotherapy to refine prognosis and, possibly, inform treatment decision-making, its value in the context of lower-intensity regimens is unclear. As such regimens have gained in popularity and can be associated with higher response rates, the need to better define the role of MRD assessment and the appropriate time points and assays used for this purpose has increased. This report outlines a roadmap for MRD testing in patients with AML treated with lower-intensity regimens. Experts from the European LeukemiaNet (ELN)-DAVID AML MRD working group reviewed all available data to propose a framework for MRD testing in future trials and clinical practice. A Delphi poll served to optimize consensus. Establishment of uniform standards for MRD assessments in lower-intensity regimens used in treating patients with AML is clinically relevant and important for optimizing testing and, ultimately, improving treatment outcomes of these patients.

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Conflict of interest statement

Conflict of interest Disclosure

F.R. has received research funding from BMS/Celgene, Amgen, Xencor, Syros, Taiho, Astex, Prelude, Biomea Fusion, Macrogenics, Hutchmed, and Abbvie; served as an advisor or received honoraria from BMS/Celgene, Novartis, Syros, Taiho, Jazz Pharmaceuticals, AstraZeneca, Agios, Abbvie, Amgen, and Xencor.

J.C. serves an advisory role for Novartis; has received research grants for her institution from Novartis, Merus, Takeda, Genentech, and BD Biosciences; and has received a royalty/license from Navigate and BD Biosciences.

F.B. serves an advisory role and is a Speaker Bureau member for Novartis.

R.D. serves an advisory role for Abbvie, Jazz Pharmacueticals, Menarini, Novartis, and Pfizer; receives research support to his institution from Abbvie, Amgen; is a consultant for Abbvie, Astellas, Jazz Pharmaceuticals, Pfizer; and is a Speaker Bureau member for Astellas, Jazz Pharmaceuticals, Novartis, and Pfizer.

K.D. serves an advisory role for Abbvie, BMS/Celgene, Daiichi Sankyo, Jazz Pharmaceuticals, Janssen, Novartis, and Roche; has received honoraria from BMS/Celgene, Daiichi Sankyo, Jazz Pharmaceuticals, Janssen, Novartis, and Roche; and has received research funding to her institution from Astellas, Agios, and Novartis.

S.D.F. has received research funding (to institution) from BMS and Jazz. Has been a consulting and received honorarium from Novartis..

C.S.H. reports that his institution receives support for his research from collaborative agreements with Sellas and the FNIH Biomarker Consortium.

G.J.O. serves an advisory role for Novartis, Pfizer, BMS, Janssen, Celgene, AGIOS, Amgen, Gilead, Astellas, Roche, Jazz Pharmaceuticals, and Merus; serves as a consultant for Janssen, Celgene, and Roche; and receives research support to his institute from Novartis, Janssen, and Celgene.

G.J.R. serves an advisory role for Abbvie, Amgen, Argenx, Astra Zeneca, Bluebird Bio, Blueprint Medicines, Bristol-Myers Squibb, Caribou Biosciences, Celgene, Daiichi Sankyo, Ellipses Pharma, GlaxoSmithKline, Janssen, Jasper Pharmaceuticals, Jazz Pharmaceuticals, Molecular Partners, Novartis, Pfizer, Rigel, Roche, Syndax, Takeda; is the Independent Review Committee (IRC) Chair for Takeda; and has received a research grants for her institute from Janssen.

M.S. serves an advisory role for Amgen, Celgene, Gilead, Janssen, Novartis, Pfizer, and Seattle Genetics; received research funding to her institution from Amgen, Gilead, Miltenyi Biotec, Morphosys, Roche, and Seattle Genetics; provided consultancy for Amgen, BMS, Celgene, Gilead, Pfizer, Novartis, and Roche; and is a Speaker Bureau member at Amgen, Celgene, Gilead, Janssen, and Pfizer.

C.T. serves an advisory role for Jazz Pharmaceuticals, Novartis; has received honoraria from Jazz Pharmaceuticals, Janssen, Novartis, Astellas, Illumina, and Thermo Fisher Scientific; has received research funding to his institution from Novartis, Jazz Pharmaceuticals; and has ownership in AgenDix.

I.A. has no disclosures

P.J.M.V. has no disclosures

A.V. serves an advisory role for Novartis, Pfizer, Jazz Pharmaceuticals, Amgen, Abbvie, Gilead, Astellas, Incyte, and Janssen & Cylag; has received research funding to the Department of Biomedicine and Prevention, University Tor Vergata from Sandoz and Jazz Pharmaceuticals; and is a Speaker Bureau member for Pfizer.

A.H.W. has served on advisory boards for Novartis, Astra Zeneca, Astellas, Janssen, Jazz, Amgen, Roche, Pfizer, Abbvie, Servier, Gilead, BMS and Beigene; has consulted for Abbvie, Servier, Novartis, Shoreline, Aculeus, receives research funding to the Institution from Novartis, Abbvie, Servier, BMS, Syndax, Astex, Astra Zeneca, Amgen; serves on speaker’s bureaus for Abbvie, Novartis, BMS, Servier, Astellas; A.H.W is an employee of the Walter and Eliza Hall Institute (WEHI). WEHI receives milestone and royalty payments related to the development of Venetoclax. Current and past employees of Walter and Eliza Hall Institute may be eligible for financial benefits related to these payments. A.H.W. receives such a financial benefit.

R.B.W. has received research grants to his institute from Amgen, Aptevo, Celgene, ImmunoGen, Janssen, Jazz, Kura, MacroGenics, and Pfizer; has ownership interests in Amphivena; and serves an advisory role for Abbvie, Adicet, Amphivena, Bergen Bio, Bristol Myers Squibb, GlaxoSmithKline, ImmunoGen, Kura, and Orum.

M.H. serves an advisory role for Abbvie, BMS, Glycostem, Servier, PinotBio, Amgen, Pfizer and LabDelbert; has received honoraria from Certara, Jazz Pharmaceuticals, Janssen, Novartis, Pfizer and Sobi; and has received research funding to his institution from Abbive, Agios, Astellas, BergenBio, BMS, Glycostem, Jazz Pharmaceuticals, Karyopharm, Loxo Oncology, and PinotBio.

Figures

Figure 1:
Figure 1:
Recommendation for timing of MRD assessment
See this image and copyright information in PMC

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