The detection of FLT3 internal tandem duplications (ITDs) MRD by next-generation sequencing (NGS) was associated with an increased risk of relapse and death among patients with acute myeloid leukemia (AML), according to the results of a study presented at the Annual Meeting of the Society of Hematologic Oncology (SOHO).
The detection of FLT3-ITDs was not feasible with polymerase chain reaction, but advances in NGS have enabled its detection. The aim of this study was to evaluate the effect of FLT3-ITD MRD detection on outcomes among patients with AML.
The study evaluated data from 161 patients with de novo AML with FLT3-ITD at diagnosis. NGS was conducted at diagnosis and when complete remission was achieved after treatment with induction chemotherapy. The endpoints were cumulative incidence of relapse (CIR) and overall survival (OS).
The CIR was significantly higher among patients with FLT3-ITD MRD detection compared with no detection (hazard ratio [HR], 3.55; 95% CI, 1.92-6.56; P <.001). OS was also significantly shorter with FLT3-ITD MRD detection (HR, 2.51; 95% CI, 1.442-4.43; P =.002).
White blood cell level of greater than 100 x 109 at diagnosis was also significantly associated with relapse (HR, 2.96; 95% CI, 1.73-5.07; P <.001) and shorter OS (HR, 1.89; 95% CI, 1.05-3.43; P =.035).
The authors concluded that “NGS-based FLT3-ITD MRD detection identifies AML patients with a profound increased risk of relapse and death that outweighs currently used prognostic factors.”
Vonk CM, Grob T, Sanders MA, et al. Prognostic value of FLT3-ITD residual disease in acute myeloid leukemia. Presented at: Annual Meeting of the Society of Hematologic Oncology (SOHO); September 28-October 1, 2022. Abstract AML-234.