Ultrasensitive Detection of Minimal Residual Disease After Allogeneic HSCT Augmented with pegIFNα in High-Risk AML Patients

Abstract

Acute Myeloid Leukemia (AML) is one of the most common types of adult leukemia. AML is the result of the failure of myeloid cells in the bone marrow to differentiate into more mature cells. The most successful treatment for patients is chemotherapy and allogenic hematopoietic stem cell transplantation (HSCT). However, HSCT is not always successful and patients with AML who relapse are less likely to survive. At the University of Michigan, 36 patients with AML that did not reach clinical remission enrolled in the pegIFNα clinical trial to test the effectiveness of pegIFNα, polyethylene glycol attached to interferon-α, accompanied with HSCT delaying or preventing relapse. Measurement of minimal residual disease (MRD) or the small number of leukemic cells present, and droplet digital PCR (ddPCR) was used in this study to indicate the likelihood of patient relapse. MRD was measured using ddPCR to see if the trial delayed or prevented relapse in patients. Out of the 36 patients, only 12 survived after four years of observation. Patients observed 56 days post treatment with minimal residual disease (MRD) present were more likely to relapse than compared to those with no MRD (p-value=0.0231). Most data in this observation was not significant due to the small sample size, but there was a noticeable prolongation of survival in patients that were MRD negative after treatment.