ArticleBlood advances2025
Pretransplant MRD does not seem to affect survival in NPM1-mutated AML undergoing allogeneic stem cell transplantation.
Article in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Optimizing treatment selection and timing of allogeneic haematopoietic stem cell transplantation in acute myeloid leukaemia with concurrent feline McDonough sarcoma (FMS)-like tyrosine kinase 3 internal tandem duplication, nucleophosmin 1 and deoxyribonucleic acid (DNA) methyltransferase 3 alpha mutations.British journal of haematology · 2026Article
- Predictive capacity of peritransplant measurable residual disease thresholds in NPM1-mutant acute myeloid leukemia.Blood advances · 2026Article
- Sequential conditioning in hematopoietic stem cell transplantation in elderly high-risk myeloid blood cancer patients: long-term survival, disease control, and immune recovery across donor types in a matched-pair analysis.Frontiers in immunology · 2026Article
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18 authors.
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Abstract
abstractWhether patients with acute myeloid leukemia (AML) harboring nucleophosmin mutations (NPM1mut) and measurable residual disease (MRD) should undergo allogeneic stem cell transplantation (allo-SCT) in complete remission (CR) remains debatable. This study assessed whether bone marrow (BM) NPM1mut MRD, detected via quantitative reverse transcription polymerase chain reaction (qRT-PCR) with 10-5 sensitivity, influences allo-SCT benefit. Data from 4 German transplantation centers included 174 patients with AML NPM1mut who underwent first allo-SCT between 2011 and 2022. Among 122 patients transplanted in CR, pre-allo-SCT MRD was positive in 54%. After allo-SCT, BM MRD negativity increased from 65% (day +30) to 73% (day +100), with FMS-like tyrosine kinase 3-internal tandem duplication and ELN risk profile affecting MRD conversion at day +30. No significant difference in leukemia-free survival (LFS) or overall survival (OS) was observed based on pretransplant MRD (3-year LFS MRD positive [MRD+], 60% vs MRD negative [MRD-], 74%; hazard ratio [HR], 1.5; P = .28; 3-year OS MRD+, 68% vs MRD-, 78%; HR, 1.42; P = .39). MRD persistence and molecular relapse outcomes did not differ (P = .8). Adverse molecular risk (HR, 4.69; P = .003) and relapsed/refractory disease (HR, 2.83/3.59; P = .005/0.001) predicted poor prognosis, while posttransplant maintenance improved survival (HR, 0.48; P = .06). Our findings suggest that in patients with NPM1mut AML MRD positivity at transplant, as assessed by qRT-PCR do not experience worse posttransplant outcomes.
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