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<p>Minimal residual disease (MRD) assessment using multiparametric flow cytometry (MFC) in acute myeloid leukaemia (AML) is a well-established predictor of relapse and survival outcome. This study aimed to evaluate the prognostic significance of MFC-based MRD assessment in AML patients managed in a real-world tertiary care setting. In this retrospective observational study, the impact of MFC-based MRD on overall survival (OS) was analysed. MRD was assessed at four predefined time points: post-induction (PI), post-consolidation (PC), pre-transplant (PT), and day 100 post-transplant (AT). Detection of MRD employed both leukaemia-associated immunophenotype (LAIP) and different-from-normal (dfN) approaches using a two-tube, 10-colour panel. Aberrant antigen expression patterns and their relevance across ELN 2022 risk categories were also examined. A total of 206 MRD assessments were performed in 125 patients, with 45 MRD-positive samples identified in 30 patients (33.8%). Among MRD-positive cases, 47% showed positivity at a single time point, while 10 patients remained positive at both PI and PC time points. MRD detection was based on the dfN approach in 15 samples and the LAIP approach in 30 samples. The most frequently observed aberrancy was CD123 (59.1%), followed by CD56 (46.1%) and CD7 (11.5%). In dfN-based analysis, abnormal expression patterns of CD64 (45%) and CD36 (9.5%), along with reduced expression of CD13 (10%) and CD45 (12.9%), were informative The median follow-up duration for the entire cohort was 12 months (range: 4–48 months), with a median overall survival (OS) of 30 months (95% CI: 18.5–41.4). Patients who were PI-MRD negative demonstrated a trend towards better OS, as compared to those who were PI-MRD positive (median OS 34 vs. 16 months; <i>p</i> = 0.173), with the most pronounced effect seen in the intermediate-risk ELN group (<i>p</i> = 0.089). MFC-based MRD assessment, particularly at the post-induction time point, rather than post-consolidation, demonstrated a trend toward prognostic relevance for overall survival in AML. CD123, CD56, CD64, and CD7 emerged as the most informative aberrant markers. MRD assessment appeared to have the greatest prognostic value in intermediate-risk AML patients, indicating its usefulness in guiding management of this heterogeneous group.</p>

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Impact of Flow Cytometry-Based MRD Detection in Predicting Outcome in Indian AML Patients: Real-World Data of 125 patients

  • 期刊论文

  • 发表日期：

    2026年8月4日

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  • Kusum Gupta,
  • Ruchi Gupta,
  • Khaliqur Rahman,
  • Deep Gala,
  • Mona Singh,
  • Manish Kumar Singh,
  • Dinesh Chandra,
  • Sanjeev Yadav,
  • Mona Vijayaran,
  • Manoj Sarkar,
  • Rajesh Kashyap

摘要

Minimal residual disease (MRD) assessment using multiparametric flow cytometry (MFC) in acute myeloid leukaemia (AML) is a well-established predictor of relapse and survival outcome. This study aimed to evaluate the prognostic significance of MFC-based MRD assessment in AML patients managed in a real-world tertiary care setting. In this retrospective observational study, the impact of MFC-based MRD on overall survival (OS) was analysed. MRD was assessed at four predefined time points: post-induction (PI), post-consolidation (PC), pre-transplant (PT), and day 100 post-transplant (AT). Detection of MRD employed both leukaemia-associated immunophenotype (LAIP) and different-from-normal (dfN) approaches using a two-tube, 10-colour panel. Aberrant antigen expression patterns and their relevance across ELN 2022 risk categories were also examined. A total of 206 MRD assessments were performed in 125 patients, with 45 MRD-positive samples identified in 30 patients (33.8%). Among MRD-positive cases, 47% showed positivity at a single time point, while 10 patients remained positive at both PI and PC time points. MRD detection was based on the dfN approach in 15 samples and the LAIP approach in 30 samples. The most frequently observed aberrancy was CD123 (59.1%), followed by CD56 (46.1%) and CD7 (11.5%). In dfN-based analysis, abnormal expression patterns of CD64 (45%) and CD36 (9.5%), along with reduced expression of CD13 (10%) and CD45 (12.9%), were informative The median follow-up duration for the entire cohort was 12 months (range: 4–48 months), with a median overall survival (OS) of 30 months (95% CI: 18.5–41.4). Patients who were PI-MRD negative demonstrated a trend towards better OS, as compared to those who were PI-MRD positive (median OS 34 vs. 16 months; p = 0.173), with the most pronounced effect seen in the intermediate-risk ELN group (p = 0.089). MFC-based MRD assessment, particularly at the post-induction time point, rather than post-consolidation, demonstrated a trend toward prognostic relevance for overall survival in AML. CD123, CD56, CD64, and CD7 emerged as the most informative aberrant markers. MRD assessment appeared to have the greatest prognostic value in intermediate-risk AML patients, indicating its usefulness in guiding management of this heterogeneous group.