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Objective <p>To evaluate the synergistic prognostic value of digital PCR (dPCR)-based multigene measurable residual disease (MRD) monitoring combined with multiparametric flow cytometry (MFC) in patients with non-transplant acute myeloid leukemia (AML).</p> Methods <p>This observational cohort study analyzed 86 newly diagnosed AML patients (excluding APL) at the Affiliated Hospital of Hebei University (January 2018–May 2025). MRD was assessed using MFC (threshold: 0.1%) and dPCR (variant allele frequency [VAF] &lt; 0.001%). Outcomes included relapse-free survival (RFS), overall survival (OS), and cumulative relapse rates.</p> Results <p>With a median follow-up time of 18.5&#xa0;months, dPCR-MRD negativity predicted superior 2-year RFS (67.1% vs 42.3%, HR = 0.365, <i>P</i> = 0.003). Combined MFC/dPCR negativity further enhanced prognostic discrimination (2-year RFS: 68.2% vs 40.5%, HR = 0.323, <i>P</i> = 0.001). Subgroup analysis revealed MFC-driven RFS benefits in intensive chemotherapy (72.2% vs 33.3%, HR = 0.180, <i>P</i> = 0.014), while dual-platform monitoring showed trends favoring non-intensive regimens (58.7% vs 31.7%, HR = 0.407,<i> P</i> = 0.051).</p> Conclusion <p>dPCR-MRD monitoring complements MFC for the stratification of risk of relapse, particularly among non-transplant AML patients. Dual-platform integration improves predictive accuracy, supporting personalized MRD-guided strategies.</p>

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Prognostic value of combined digital PCR and multiparametric flow cytometry monitoring MRD in non-transplant acute myeloid leukemia

  • 期刊论文

  • 发表日期：

    2026年4月14日

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  • Shaojie Ye,
  • Huimei Guo,
  • Jianmei Xu,
  • Xi Su,
  • Lin Wang,
  • Jiangbo Zhang,
  • Jia Liu,
  • Songying Zhao,
  • Jing Wang,
  • Hua Xue

摘要

Objective

To evaluate the synergistic prognostic value of digital PCR (dPCR)-based multigene measurable residual disease (MRD) monitoring combined with multiparametric flow cytometry (MFC) in patients with non-transplant acute myeloid leukemia (AML).

Methods

This observational cohort study analyzed 86 newly diagnosed AML patients (excluding APL) at the Affiliated Hospital of Hebei University (January 2018–May 2025). MRD was assessed using MFC (threshold: 0.1%) and dPCR (variant allele frequency [VAF] < 0.001%). Outcomes included relapse-free survival (RFS), overall survival (OS), and cumulative relapse rates.

Results

With a median follow-up time of 18.5 months, dPCR-MRD negativity predicted superior 2-year RFS (67.1% vs 42.3%, HR = 0.365, P = 0.003). Combined MFC/dPCR negativity further enhanced prognostic discrimination (2-year RFS: 68.2% vs 40.5%, HR = 0.323, P = 0.001). Subgroup analysis revealed MFC-driven RFS benefits in intensive chemotherapy (72.2% vs 33.3%, HR = 0.180, P = 0.014), while dual-platform monitoring showed trends favoring non-intensive regimens (58.7% vs 31.7%, HR = 0.407, P = 0.051).

Conclusion

dPCR-MRD monitoring complements MFC for the stratification of risk of relapse, particularly among non-transplant AML patients. Dual-platform integration improves predictive accuracy, supporting personalized MRD-guided strategies.