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Objective <p>Measurable residual disease (MRD) is a key prognostic factor for outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloid leukemia. To enhance predictive performance, we developed a combined MRD assessment method that integrates the proportion of residual leukemic cells of ten-color multicolor flow cytometry (MFC) with peripheral blood WT1 mRNA expression.</p> Methods <p>Forty-six patients with acute myeloid leukemia who underwent allo-HSCT at our institution between October 2013 and December 2019 were enrolled. We prospectively analyzed the prognostic impact of ten-color MFC, peripheral blood WT1 mRNA, and combined MRD assessment before transplantation.</p> Results <p>Both ten-color MFC-based MRD and peripheral blood WT1 mRNA levels above predefined thresholds were significantly associated with an increased risk of relapse after allo-HSCT. However, the results of the multivariate and ROC analyses suggest that ten-color MFC may be a stronger predictor than WT1 mRNA. Moreover, adding peripheral blood WT1 mRNA to ten-color MFC-based MRD reduced the predictive accuracy compared with MFC alone.</p>

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Ten-color multicolor flow cytometry-based measurable residual disease at pre-transplantation predicts relapse of acute myeloid leukemia: a prospective study

  • 期刊论文

  • 发表日期：

    2026年4月7日

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  • Kumiyo Tazoe,
  • Hirohisa Nakamae,
  • Yosuke Makuuchi,
  • Masatomo Kuno,
  • Teruhito Takakuwa,
  • Hiroshi Okamura,
  • Asao Hirose,
  • Mika Nakamae,
  • Mitsutaka Nishimoto,
  • Yasuhiro Nakashima,
  • Hideo Miyagawa,
  • Masayuki Hino

摘要

Objective

Measurable residual disease (MRD) is a key prognostic factor for outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloid leukemia. To enhance predictive performance, we developed a combined MRD assessment method that integrates the proportion of residual leukemic cells of ten-color multicolor flow cytometry (MFC) with peripheral blood WT1 mRNA expression.

Methods

Forty-six patients with acute myeloid leukemia who underwent allo-HSCT at our institution between October 2013 and December 2019 were enrolled. We prospectively analyzed the prognostic impact of ten-color MFC, peripheral blood WT1 mRNA, and combined MRD assessment before transplantation.

Results

Both ten-color MFC-based MRD and peripheral blood WT1 mRNA levels above predefined thresholds were significantly associated with an increased risk of relapse after allo-HSCT. However, the results of the multivariate and ROC analyses suggest that ten-color MFC may be a stronger predictor than WT1 mRNA. Moreover, adding peripheral blood WT1 mRNA to ten-color MFC-based MRD reduced the predictive accuracy compared with MFC alone.