Prognostic value of residual disease detection in acute myeloid leukemia with normal karyotype and negative FLT3-ITD

Introduction: Complete remission (CR) in patients with acute myeloid leukemia (AML) is still morphologicaly defined, thus correspon-ding to a wide range of tumor burden. Objectives: we aimed to evaluate the residual disease (MRD) status in patients with AML, as well as per-form a molecular analysis of the FLT3/ITD gene in patients with normal karyotype. Material and methods: adult patients with AML, diagnosed according to the WHO 2016 criteria, were included. MRD was detec-ted using flow cytometric techniques after induction treatment resulting in CR. Results: thirty patients met our inclusion criteria. 83 % of them had an intermediate risk status, 67 % of which (20/30) having a normal karyotype. MRD and leukemic stem cell (LSC) positivity in this group was predominant with considerable decrease in benign progenitor count. The relapse-free survival (RFS) in the group of MRD negative patients with normal cytogenetics and non-mutated FLT3 gene was better than the RFS in all of our patients studied. Conclusion: MRD and LSC are powerful prognostic factors for relapse. They should be routinely integrated to guide better management of AML