4/25/2023 0 Comments Minimal residual disease![]() A comparison of sequencing with flow cytometry for the detection of residual disease showed that sequencing had significant additive prognostic value. Multivariate analysis confirmed that the persistence of non- DTA mutations during complete remission conferred significant independent prognostic value with respect to the rates of relapse (hazard ratio, 1.89 P<0.001), relapse-free survival (hazard ratio for relapse or death, 1.64 P=0.001), and overall survival (hazard ratio for death, 1.64 P=0.003). 58.1% hazard ratio for relapse or death, 1.92 P<0.001) and overall survival (41.9% vs. 31.9% hazard ratio, 2.14 P<0.001), as well as with lower rates of relapse-free survival (36.6% vs. After the exclusion of persistent DTA mutations, the detection of molecular minimal residual disease was associated with a significantly higher relapse rate than no detection (55.4% vs. The detection of persistent DTA mutations (i.e., mutations in DNMT3A, TET2, and ASXL1), which are often present in persons with age-related clonal hematopoiesis, was not correlated with an increased relapse rate. Mutations persisted in 51.4% of those patients during complete remission and were present at various allele frequencies (range, 0.02 to 47%). ResultsĪt least one mutation was detected in 430 out of 482 patients (89.2%). End points were 4-year rates of relapse, relapse-free survival, and overall survival. Targeted next-generation sequencing was carried out at diagnosis and after induction therapy (during complete remission). We conducted a study involving patients 18 to 65 years of age who had newly diagnosed AML. Next-generation sequencing enables the detection of molecular minimal residual disease in virtually every patient, but its clinical value for the prediction of relapse has yet to be established. Patients with acute myeloid leukemia (AML) often reach complete remission, but relapse rates remain high. The most trusted, influential source of new medical knowledge and clinical best practices in the world. ![]() Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.
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