Highlights from

ASH 2020

62nd Annual Meeting & Exposition of the American Society of Hematology

Virtual 5 - 8 December 2020

Peripheral blood monitoring offers a viable alternative to monitor treatment response in acute lymphoblastic leukaemia

A new observational study showed a strong correlation between peripheral blood and bone marrow next generation sequencing (NGS) measurable residual disease results in acute lymphoblastic leukaemia [1]. These results demonstrate that non-invasive peripheral blood monitoring can be a viable alternative to serial bone marrow evaluation.

The current gold standard for measurable residual disease (MRD) assessment of acute lymphoblastic leukaemia dictates serial bone marrow examination, which is both invasive and expensive. Researchers executed a prospective, multicentre observational study that explored the use of NGS using peripheral blood to monitor treatment response/disease progression.

The study, presented by Dr Lori Muffly (Stanford University, California, USA), enrolled 69 patients receiving cellular therapies (haematopoietic cell transplantation [HCT] or chimeric antigen receptor T cell [CAR-T] therapy). The Adaptive Biotechnologies ClonoSEQ NGS platform provided MRD analyses of peripheral blood for comparison with bone marrow analyses. All patients obtained peripheral blood and bone marrow analyses prior to undergoing the therapeutic procedure. HCT patients then had their peripheral blood analysed at 1 month and then every 2-3 months for the first year following the therapy, and their bone marrow analysed at 3 months. CAR-T patients had both peripheral blood and bone marrow analyses completed at 1 month and then every 2-3 months for the first year post-procedure.

The Pearson correlation coefficient revealed a high correlation of peripheral blood MRD with bone marrow MRD in all patients (r=0.87; P<0.0001), indicating that monitoring of MRD using peripheral blood analysis offers a non-invasive alternative to bone marrow analysis.

NGS MRD monitoring also offered clinical utility to predict clinical relapse (defined as morphologic leukaemia blasts in the marrow or extramedullary site, or administration of a new therapy for rising MRD). There were 6 (13%) patients who experienced clinical relapse following HCT; all 6 had detectable MRD using peripheral blood analysis. Among the 13 patients (65%) who experienced clinical relapse following CAR-T, 85% had detectable MRD using peripheral blood analysis.

  1. Muffly L, et al. Monitoring Measurable Residual Disease Using Peripheral Blood in Acute Lymphoblastic Leukemia: Results of a Prospective, Observational Study. 62nd ASH Annual Meeting, December 5-8, 2020. Abstract 975.

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