Measurable residual disease by flow cytometry in acute myeloid leukemia is prognostic, independent of genomic profiling

Chezi Ganzel, Zhuoxin Sun, Timour Baslan, Yanming Zhang, Mithat Gönen, Omar I. Abdel-Wahab, Janis Racevskis, Francine Garrett-Bakelman, Scott W. Lowe, Hugo F. Fernandez, Rhett Ketterling, Selina M. Luger, Mark Litzow, Hillard M. Lazarus, Jacob M. Rowe, Martin S. Tallman, Ross L. Levine, Elisabeth Paietta

Research output: Contribution to journalArticlepeer-review


Measurable residual disease (MRD) assessment provides a potent indicator of the efficacy of anti-leukemic therapy. It is unknown, however, whether integrating MRD with molecular profiling better identifies patients at risk of relapse. To investigate the clinical relevance of MRD in relation to a molecular-based prognostic schema, we measured MRD by flow cytometry in 189 AML patients enrolled in ECOG-ACRIN E1900 trial (NCT00049517) in morphologic complete remission (CR) (28.8 % of the original cohort) representing 44.4 % of CR patients. MRD positivity was defined as ≥ 0.1 % of leukemic bone marrow cells. Risk classification was based on standard cytogenetics, fluorescence-in-situ-hybridization, somatic gene analysis, and sparse whole genome sequencing for copy number ascertainment. At 84.6 months median follow-up of patients still alive at the time of analysis (range 47.0–120 months), multivariate analysis demonstrated that MRD status at CR (p = 0.001) and integrated molecular risk (p = 0.0004) independently predicted overall survival (OS). Among risk classes, MRD status significantly affected OS only in the favorable risk group (p = 0.002). Expression of CD25 (α-chain of the interleukin-2 receptor) by leukemic myeloblasts at diagnosis negatively affected OS independent of post-treatment MRD levels. These data suggest that integrating MRD with genetic profiling and pre-treatment CD25 expression may improve prognostication in AML.

Original languageEnglish (US)
Article number106971
JournalLeukemia Research
StatePublished - Dec 2022


  • Acute myeloid leukemia
  • CD25
  • Flow cytometry
  • Genomic profiling
  • MRD
  • Measurable residual disease
  • Minimal residual disease

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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