Fig. 4: Implications for measurable residual disease surveillance and transplant outcomes.
From: Unified classification and risk-stratification in Acute Myeloid Leukemia
a Cumulative incidence of relapse and Kaplan–Meier overall survival curves for patients that attained CR in AML17 trial subset, stratified by MRD status post course 1 (n = 523). Two-sided Gray’s test and the logrank test were used to compare the relapse incidence and survival, respectively. b Barplots indicating proportion of patients in each molecular class with flow MRD +ve (any detectable MRD) or MRD−ve status post course 1. Restricted to the AML17 trial subset (n = 523) and to classes with at least five patients in the MRD + ve subset. c Incidence of relapse and OS by MRD status for the sAML2, sAML1 subgroups. A test for interaction between sAML1 vs sAML2 and MRD (Interaction HR: 1.90 (0.55–6.49), p-value: 0.31) was not significant. The analysis provided in c is limited to AML17 patients with MRD data available. Two-sided Gray’s test and the logrank test were used to compare the relapse incidence and survival, respectively. d Nonparametric estimated curves of the hazard rate (deaths per person-year; y-axis) across time (x-axis) for the sAML2, sAML1 and TP53 complex subgroups in the combined dataset (UK-NCRI and AMLSG). Curves display the hazard for patients transplanted (TPL) in CR1 to the non-transplanted patients. Tests of association were modeling transplant as a time-dependent covariate adjusted for age and performance status. A test for interaction between sAML1 vs sAML2 and transplant was borderline significant (Interaction HR: 0.57 (0.30–1.08), p-value: 0.08). 95% CIs are shown in the shaded areas. e Kaplan–Meier overall survival curves comparing patients who have been transplanted in CR1 to patients transplanted in CR2 for the selected classes. P-values are computed using the log-rank test. The analysis in d, e is limited to the patients to 2244 intensively treated patients in the UK-NCRI (n = 1095) and AMLSG (total n = 1149) that achieved CR, 759 patients were transplanted in CR1 and 436 after relapse (Total n = 1195).
