Strong correlation between peripheral blood and bone marrow NGS MRD

A prospective observational study demonstrated a strong correlation between measurable residual disease (MRD) analysis by next-generation sequencing (NGS) using either peripheral blood or bone marrow in acute lymphoblastic leukaemia (ALL). These results show that non-invasive monitoring of peripheral blood MRD represents a viable alternative to serial bone marrow examinations.

The prognostic and predictive utility of MRD assessments using bone marrow aspirates is well-established in the management of ALL. However, frequent bone marrow MRD monitoring post-therapy is limited by the invasive, expensive, and at times impractical nature of numerous bone marrow examinations. Limited retrospective reports have suggested that NGS MRD using peripheral blood may provide a viable alternative to MRD monitoring of the bone marrow.

Dr Lori Muffly (Stanford University, California, USA) and colleagues conducted a prospective, multi-institutional observational study of NGS-based MRD of the peripheral blood among 62 adult ALL patients undergoing cellular therapies, namely haematopoietic cell transplantation (HCT) and chimaeric antigen receptor T cells (CAR T), to determine the correlation between peripheral blood and bone marrow MRD and to explore the clinical utility of monitoring MRD in the peripheral blood [1].

Median age of patients was 42 years, 36 (58%) were male, 54 (87%) had B-cell ALL, 16 (26%) were BCR-ABL+, and 28 (46%) had extramedullary involvement. Across all patients, peripheral blood MRD was highly correlated with bone marrow MRD (r=0.87; P<0.0001). Of the 129 paired samples, 15 (12%) had discordance with MRD identified in either the peripheral blood and not bone marrow (5%) or in the bone marrow and not peripheral blood (6%). Similarly, peripheral blood and bone marrow MRD were highly correlated in the HCT (r=0.86; P<0.0001) and CAR T cohorts (r=0.86; P<0.001) [1].

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

Posted on 18 February 202122 February 2021