MRD in ASC samples linked to high risk of relapse post-ASCT in R/R DLBCL

Merryman RW, Redd RA, Taranto E, et al. Minimal Residual Disease in Patients with Diffuse Large B-Cell Lymphoma Undergoing Autologous Stem Cell Transplantation. Blood Advances. 2022; (doi: 10.1182/bloodadvances.2022007706).

The results of a new study indicate that minimal residual disease (MRD) detected in apheresis stem cell (ASC) samples is linked to a very high risk of relapse following autologous stem cell transplantation (ASCT) among patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). The study included 159 ASCT recipients with R/R DLBCL, including 98 who had an ASC sample and 60 who had post-ASCT surveillance samples. The 5-year progression-free survival (PFS) rate was 48%. Overall, MRD was detected in 23% of the ASC samples. Five-year PFS in this group was just 13%, compared with 53% when ASC MRD was not detected.  Overall survival in this group was 52% vs. 68%. ASC MRD positivity for progression or death yielded 36% sensitivity and 93% specificity. Detection of MRD in ASC samples was a key predictor of PFS in multivariable analysis. Surveillance MRD testing from plasma samples post-ASTC reliably identified patients with impending relapse. Analysis showed inferior PFS corresponding with detection of plasma MRD, and the median lead time from MRD detection to relapse was 62 days. Researchers suggest that since MRD in ASC samples is associated with a very high relapse risk, alternative treatment strategies or trials of novel consolidation options may be beneficial for these patients, and post-ASTC MRD monitoring useful to evaluate early interventions.  .

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Tags: MRD, study, patient care, transplantation, Relapse, Cellular therapy, Survival, Stem Cells, Stem Cell, Transplant, cell therapy, Autologous, survival rate, risk factors, measurable residual disease

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