Predicting AML relapse with PB TA-cfDNA post-ASCT
Patel V, Kabat M, Ip A, et al. Peripheral Blood Tumor Associated Cell-Free DNA Testing as a Predictor for Relapse Post-Allogeneic Stem Cell Transplant for AML. Transplantation and Cellular Therapy. 2025; (doi: 10.1016/j.jtct.2025.08.010).
Checking for tumor-associated circulating cell-free DNA (TA-cfDNA) after allogeneic stem cell transplantation for acute myelogenous leukemia (AML) could serve as a predictive marker for relapse risk, study findings suggest. Researchers retrospectively analyzed results from 90 AML transplant recipients who had their procedure during 2018-2022 and whose peripheral blood (PB) was screened for TA-cfDNA 100-200 days afterward. Participants were considered positive for TA-cfDNA if tests showed tumor-associated genomic alterations with variant allele frequency greater than 0.01%, and they were considered negative if these genomic alterations were not present. Analysis determined that patients testing positive for PB TA-cfNDA at day 150±50 days had markedly worse overall survival (hazard ratio [HR] 5.4 with 95% confidence interval [CI] 2.5 to 11.8, p<0.0001) and relapse-free survival (HR 5.2, 95% CI 2.4 to 11.3, p<0.0001) than did patients with negative results. Unfavorable outcomes corresponded with persistent adverse mutations consistent with TA-cfDNA in PB post-transplant. Screening as a predictive marker might equip clinicians to intervene earlier in terms of post-transplant treatment strategies, researchers conclude.