Prognostic Value of Dynamic Measurable Residual Disease Monitoring by Multiflowcytometry in Elderly Patients With Nonintensively Treated Acute Myeloid Leukemia

Purpose: The clinical prognostic value of monitoring minimal residual disease (MRD) in acute myeloid leukemia (AML) patients undergoing nonintensive treatment remains insufficiently established. The aim of this work was to examine MRD status at various time points, highlighting the potential for pre-emptive therapy to improve patient outcomes.

Methods: Inpatient data from 2017 to 2024 were used in this retrospective study. Bone marrow samples were analyzed for MRD using multiparametric flow cytometry at the end of cycles 1, 2, 4, and 7, before the next therapy course. Kaplan-Meier method and Cox regression were used to assess factors affecting overall survival (OS) and disease-free survival (DFS), and logistic regression evaluated the interaction between MRD and baseline features.

Results: A total of 108 patients were enrolled for MRD evaluation. MRD1, MRD2, MRD4, and MRD7 was significantly associated with both OS and DFS. Early MRD negativity leads to longer survival time, and the later MRD turns negative, the higher the risk of relapse, and ELN 2017 high risk and myeloid gene mutation are adverse factors affecting time to MRD negative status.

Conclusion: Dynamic MRD monitoring has predictive value for nonintensive treatment in AML patients. Proper use of MRD and baseline features allows treatment adjustments based on an accurate estimation of relapse risk.