A new study has shown that a leukaemia stem cell (LSC)-based test may outperform traditional methods in predicting relapse in acute myeloid leukaemia (AML) patients after stem cell transplant. The research, which followed 360 AML patients who underwent allogeneic transplants between July 2018 and November 2019, offers a promising approach to long-term monitoring and early intervention.
Researchers compared measurable residual disease (MRD) detection using two approaches: a traditional multiparameter flow cytometry (MFC) assay and an LSC-based method that identifies CD34+CD38− leukaemia stem cells. Patients with MRD detected by the LSC assay had a significantly higher five-year cumulative incidence of relapse (49.7%) than those without detectable LSCs (8.5%). These patients also had markedly lower five-year leukaemia-free survival (48.2% vs. 84.4%) and overall survival rates (59.7% vs. 82.8%).
While traditional MFC-MRD testing also identified patients at risk of relapse, the LSC-based method showed higher sensitivity (52.4% vs. 33.3%) and stronger predictive power, with a higher concordance index (0.72 vs. 0.65) and Youden index (0.44 vs. 0.27). Additionally, the LSC assay predicted relapse further in advance, with a median lead time of 144 days versus 65 days for traditional MFC.
The findings suggest that incorporating LSC-based MRD testing into post-transplant care for AML patients could allow for earlier clinical intervention and improved long-term outcomes.
Reference
Li SQ et al. Leukemia stem cells for relapse prediction in AML patients receiving allografts: long-term follow-up of a prospective study. Bone Marrow Transplant. 2025; https://doi.org/10.1038/s41409-025-02699-8.
