Persistent or new cytopenias predict relapse better than routine bone marrow aspirate evaluations after hematopoietic cell transplantation for acute leukemia or myelodysplastic syndrome in children and young adult patients

Allogeneic hematopoietic cell transplantation (alloHCT) offers a curative approach to children with high-risk leukemia, refractory leukemia, and myelodysplastic syndrome (MDS) with survival rates ranging from 50% to 70%.1,2. Relapse within the first two years after HCT is the most common cause of treatment failure.1,3,4 Among pediatric transplantation providers there is growing consensus regarding appropriate patient and donor selection, cytoreduction and source of stem cells.2 Although detection of bone marrow (BM) minimal residual disease (MRD) by multiparameter flow cytometry (MFC, MFC-MRD) or next generation sequencing (NGS) for clonal mutations pre or post HCT are associated with relapse,3-7 guidelines for timing and testing of bone marrow aspirates (BMAs) to monitor disease recurrence post transplantation are lacking and the clinical value of routine BMA (rBMAs) in the first year after HCT to detect or predict relapse of acute leukemia (AL) and myelodysplastic syndrome (MDS) is unclear.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research