Assessment of Measurable Residual Disease on Day 28 of First Induction Chemotherapy in Acute Myeloid Leukaemia Patients

Nasrin Akhter(1), Raiq Raihan Chowdhury(2), Md. Maruf Reza Kabir(3), Sorowar Jahan Rajib(4), Mily Dey(5), Papri Nasrin(6), Sharup Chandra Poddar(7), Ismat Ara Islam(8), Aminur Rahman(9), Md. Salahuddin Shah(10)
(1) Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
(2) Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
(3) Dhaka Medical College, Dhaka, Bangladesh
(4) National Institute of Cancer Research & Hospital, Mohakhali, Dhaka, Bangladesh
(5) Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh
(6) Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh
(7) Dhaka Medical College, Dhaka, Bangladesh
(8) Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
(9) Sheikh Hasina Medical College, Tangail, Bangladesh, Bangladesh
(10) Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh

Abstract

Background: Measurable residual disease (MRD) is an independent, strong, prognostic marker in acute myeloid leukaemia (AML) that is important for risk stratification and treatment planning. This study assessed the MRD on day-28 after first induction chemotherapy in AML patients. Objective: To assess measurable residual disease status on day 28 after the first induction chemotherapy in newly diagnosed acute myeloid leukaemia patients. Methodology: This cross-sectional study was conducted at the Department of Haematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2021 to March 2022 among a total of 25 newly diagnosed AML patients who were admitted and received induction chemotherapy with DA (7+3). On Day-28, bone marrow aspiration was done with standard procedure and first pull of 2ml bone marrow sample was sent to a laboratory for MRD evaluation by multiparameter flow cytometry. MRD was considered positive when value was ?0.1%. Results: On day 28 of post induction chemotherapy most of the patients (92%) achieved morphological remission and among them more than half (52.2%) were MRD positive. The presence of CD14 myeloid marker and baseline higher serum uric acid level was significant in MRD positive patients and cytarabine dose 150 mg/m2 was found significant in MRD negative patients. Conclusion: More than half of the Acute Myeloid Leukaemia patients, treated with standard induction chemotherapy and achieved morphological remission on day 28 of chemotherapy, had positive measurable residual disease assessed by multiparameter flow cytometry. Positive MRD indicates relatively poorer prognosis and may necessitate more cycles of induction followed by more intensive consolidation which may include haematopoietic stem cell transplantation.

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Authors

Nasrin Akhter
shumi.doc.ns@gmail.com (Primary Contact)
Raiq Raihan Chowdhury
Md. Maruf Reza Kabir
Sorowar Jahan Rajib
Mily Dey
Papri Nasrin
Sharup Chandra Poddar
Ismat Ara Islam
Aminur Rahman
Md. Salahuddin Shah
Author Biography

Nasrin Akhter, Bangabandhu Sheikh Mujib Medical University, Dhaka

Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

1.
Akhter N, Chowdhury RR, Kabir MMR, Rajib SJ, Dey M, Nasrin P, et al. Assessment of Measurable Residual Disease on Day 28 of First Induction Chemotherapy in Acute Myeloid Leukaemia Patients. Haematol J Bangladesh [Internet]. 2024 Feb. 20 [cited 2024 Apr. 17];8(1):03-1. Available from: https://journal.hematologybd.org/index.php/haematoljbd/article/view/118

Article Details

How to Cite

1.
Akhter N, Chowdhury RR, Kabir MMR, Rajib SJ, Dey M, Nasrin P, et al. Assessment of Measurable Residual Disease on Day 28 of First Induction Chemotherapy in Acute Myeloid Leukaemia Patients. Haematol J Bangladesh [Internet]. 2024 Feb. 20 [cited 2024 Apr. 17];8(1):03-1. Available from: https://journal.hematologybd.org/index.php/haematoljbd/article/view/118

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