{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:03:41Z","timestamp":1780045421624,"version":"3.53.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Myelodysplastic syndromes (MDS) are heterogenous disorders in which response assessment remains challenging. In acute myeloid leukemia (AML), measurable residual disease (MRD) by multiparametric flow cytometry (MFC) is prognostic and guides decision\u2010making after two cycles of intensive chemotherapy, but its role in high\u2010risk MDS (hrMDS) is unknown. We aimed to determine the prognostic impact of MFC\u2010MRD (0.1% cutoff) for overall survival (OS) and the cumulative incidence of relapse (CIR) in intensively treated hrMDS. After stringent selection from 3269 patients enrolled in prior HOVON\u2010SAKK MDS\/AML trials, we identified 91 ICC 2022\u2010defined hrMDS patients with available MFC\u2010MRD. MFC\u2010MRD positivity was detected in 24% and associated with inferior survival (5\u2010year OS: 22.7% vs. 43.7%; P\u2009=\u20090.010) and higher relapse risk (5\u2010year CIR: 72.7% vs. 47.2%; P\u2009=\u20090.014). In multivariable analyses stratified by trial and adjusted for, among others, the presence of a biallelic\n                    <jats:italic>TP53<\/jats:italic>\n                    mutation, MFC\u2010MRD positivity remained associated with poorer OS (hazard ratio (HR) 2.12 [95% CI 1.15\u20133.90]; P\u2009=\u20090.017) and increased CIR (subdistribution HR 2.15 [95% CI 1.11\u20134.14]; P\u2009=\u20090.022). To account for the potential confounding effect of allogeneic hematopoietic stem cell transplantation, additional sensitivity analyses were performed and confirmed that MRD positivity remained significantly associated with inferior survival outcomes. Lastly, an exploratory cross\u2010disease comparison showed that MRD\u2010negative (MRDneg) hrMDS patients had similar survival outcomes to MRD\u2010positive (MRDpos) AML patients. These findings demonstrate the prognostic value of MFC\u2010MRD in intensively treated hrMDS and provide rationale for prospective trials of MRD\u2010informed transplant and post\u2010remission strategies.\n                  <\/jats:p>","DOI":"10.1002\/hem3.70379","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:49:57Z","timestamp":1779385797000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of measurable residual disease in high\u2010risk MDS after intensive chemotherapy in HOVON\u2010SAKK studies"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6068-9198","authenticated-orcid":false,"given":"Coen R.","family":"Veenstra","sequence":"first","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lok Lam","family":"Ngai","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrycja","family":"Gradowska","sequence":"additional","affiliation":[{"name":"Department of Hematology Erasmus University Medical Center Cancer Institute Rotterdam The Netherlands"},{"name":"HOVON Foundation Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurjen","family":"Versluis","sequence":"additional","affiliation":[{"name":"Department of Hematology Erasmus University Medical Center Cancer Institute Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1346-6606","authenticated-orcid":false,"given":"Tom","family":"Reuvekamp","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"},{"name":"Department of Hematology Amsterdam UMC location Universiteit van Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e8le","family":"Kelder","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willemijn","family":"Scholten","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Snel","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse M.","family":"Tettero","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costa","family":"Bachas","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri A.","family":"Breems","sequence":"additional","affiliation":[{"name":"Department of Hematology Ziekenhuis aan de Stroom Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Fischer","sequence":"additional","affiliation":[{"name":"Otto von Guericke University Hospital Magdeburg Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9358-9704","authenticated-orcid":false,"given":"Bj\u00f8rn T.","family":"Gjertsen","sequence":"additional","affiliation":[{"name":"Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laimonas","family":"Griskevicius","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos and Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Juliusson","sequence":"additional","affiliation":[{"name":"Skanes University Hospital Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan A.","family":"Maertens","sequence":"additional","affiliation":[{"name":"University Hospital Gasthuisberg Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4676-7931","authenticated-orcid":false,"given":"Markus G.","family":"Manz","sequence":"additional","affiliation":[{"name":"University Hospital Zurich Zurich Switzerland"},{"name":"Swiss Group for Clinical Cancer Research (SAKK) Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Pabst","sequence":"additional","affiliation":[{"name":"Swiss Group for Clinical Cancer Research (SAKK) Bern Switzerland"},{"name":"Department of Medical Oncology Inselspital, University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob R.","family":"Passweg","sequence":"additional","affiliation":[{"name":"Swiss Group for Clinical Cancer Research (SAKK) Bern Switzerland"},{"name":"University Hospital Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimmo","family":"Porkka","sequence":"additional","affiliation":[{"name":"Helsinki University Hospital Cancer Center Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canan","family":"Alhan","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresia M.","family":"Westers","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"de Leeuw","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"L\u00f6wenberg","sequence":"additional","affiliation":[{"name":"Department of Hematology Erasmus University Medical Center Cancer Institute Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert J.","family":"Ossenkoppele","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Cloos","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjan A.","family":"van de Loosdrecht","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V89.6.2079"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2200008"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26984"},{"issue":"17","key":"e_1_2_11_6_1","first-page":"2047","article-title":"Consensus proposal for revised International Working Group 2023 response criteria for higher\u2010risk myelodysplastic syndromes","volume":"141","author":"Zeidan AM","year":"2023","journal-title":"Blood"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023010098"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16081503"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022016867"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021013626"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2025031480"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01657-3"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003855"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-10-740613"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-04-420596"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.9628"},{"key":"e_1_2_11_17_1","unstructured":"Randomized study to assess the added value of Laromustine in combination with standard remission\u2010induction chemotherapy in patients aged 18\u201065 years with previously untreated acute myeloid leukemia (AML) or myelodysplasia (MDS) (RAEB with IPSS \u2265 1.5)[CCMO Code: NL22762.078.08]HOVON. 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