The Impact of DNMT3A Status on NPM1 MRD Predictive Value and Survival in Elderly AML Patients Treated Intensively.

Minimal residual disease (MRD) is now a powerful surrogate marker to assess the response to chemotherapy in acute myeloid leukemia (AML). mutation has been associated with adverse outcomes. In this study, we aimed to investigate the impact of status on NPM1 MRD predictive value for survival in a retrospective cohort of AML patients aged over 60 years old treated intensively. A total of 138 patients treated for -mutated AML in two French institutions were analyzed retrospectively. status did not influence the probability of having a ≥ 4log MRD1 reduction after induction. Only 20.4% of patients reached ≥ 4log MRD1 reduction compared to 47.5% in wt cases. A 4log reduction of MRD was associated with a better outcome, even in mutated patients, independent of the allelic ratio. negative patients who reached a 4log reduction had a superior outcome to those who did not (HR = 0.23; < 0.001). However, postinduction MRD1 reduction was not predictive of OS and LFS in mut patients. These results confirm that post-induction MRD1 is a reliable tool to assess disease outcome in elderly AML patients. However, the presence of also identifies a subgroup of patients at high risk of relapse.