{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:45:43Z","timestamp":1788983143242,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The measurement of minimal residual disease (MRD) by multiparametric flow cytometry (MFC) before hematopoietic stem cell transplantation (HSCT) in patients with acute myeloid leukemia (AML) is a powerful prognostic factor. The interaction of pretransplant MRD and the conditioning intensity has not yet been clarified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study is to analyze the transplant outcomes of patients with AML who underwent HSCT in complete remission (CR), comparing patients with positive MRD (MRD+) and negative MRD (MRD\u2212) before HSCT, and the interaction between conditioning intensity and pre-HSCT MRD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>We retrospectively analyzed the transplant outcomes of 118 patients with AML who underwent HSCT in CR in a single institution, comparing patients with MRD+ and MRD\u2212 before HSCT using a cutoff of 0.1% on MFC, and the interaction between conditioning intensity and pre-HSCT MRD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with MRD+ before HSCT had a significantly worse 2-year (2y) event-free survival (EFS) (56.5% vs. 32.0%, <jats:italic>p<\/jats:italic> = 0.018) than MRD\u2212 patients, due to a higher cumulative incidence of relapse (CIR) at 2 years (49.0% vs. 18.0%, <jats:italic>p<\/jats:italic> = 0.002), with no differences in transplant-related mortality (TRM) (2y-TRM, 19.0% and 25.0%, respectively, <jats:italic>p<\/jats:italic> = 0.588). In the analysis stratified by conditioning intensity, in patients who received MAC, those with MRD\u2212 before HSCT had better EFS (<jats:italic>p<\/jats:italic> = 0.009) and overall survival (OS) (<jats:italic>p<\/jats:italic> = 0.070) due to lower CIR (<jats:italic>p<\/jats:italic> = 0.004) than MRD+ patients. On the other hand, the survival was similar in reduced intensity conditioning (RIC) patients regardless of the MRD status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with MRD+ before HSCT have worse outcomes than MRD\u2212 patients. In patients who received MAC, MRD\u2212 patients have better EFS and OS due to lower CIR than MRD+ patients, probably because they represent a more chemo-sensitive group. However, among RIC patients, results were similar regardless of the MRD status.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1394648","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T08:06:40Z","timestamp":1714637200000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Survival after allogeneic transplantation according to pretransplant minimal residual disease and conditioning intensity in patients with acute myeloid leukemia"],"prefix":"10.3389","volume":"14","author":[{"given":"Claudia","family":"N\u00fa\u00f1ez-Torr\u00f3n Stock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Jim\u00e9nez Chill\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Mart\u00edn Moro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Marquet Palomanes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Piris Villaespesa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Rold\u00e1n Santiago","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eulalia","family":"Rodr\u00edguez Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabelle","family":"Chinea Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valent\u00edn","family":"Garc\u00eda Guti\u00e9rrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Moreno Jim\u00e9nez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"L\u00f3pez Jim\u00e9nez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Herrera Puente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16355","article-title":"The role of allogeneic stem cell transplantation in the management of acute myeloid leukaemia: a triumph of hope and experience","volume":"188","author":"Loke","year":"2020","journal-title":"Br J Haematol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-05-2004","article-title":"Hematopoietic cell transplantation (HCT)-specific comorbidity index: A new tool for risk assessment before allogeneic HCT","volume":"106","author":"Sorror","year":"2005","journal-title":"Blood"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001904","article-title":"Prognostic impact of the ELN2017 risk classification in patients with AML receiving allogeneic transplantation","volume":"4","author":"Grimm","year":"2020","journal-title":"Blood Adv"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.03011","article-title":"Impact of conditioning intensity of allogeneic transplantation for acute myeloid leukemia with genomic evidence of residual disease","volume":"38","author":"Hourigan","year":"2019","journal-title":"J Clin Oncol [Internet]"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.02308","article-title":"Augmented reduced-intensity regimen does not improve postallogeneic transplant outcomes in acute myeloid leukemia","volume":"39","author":"Craddock","year":"2020","journal-title":"J Clin Oncol [Internet]"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.178251","article-title":"Allogeneic stem cell transplantation benefits for patients \u2265 60 years with acute myeloid leukemia and flt3 internal tandem duplication: A study from the acute leukemia working party of the european society for blood and marrow transplantation","volume":"103","author":"Poir\u00e9","year":"2018","journal-title":"Haematologica"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2017.61","article-title":"Allogeneic transplantation in primary refractory AML","volume":"52","author":"Ferguson","year":"2017","journal-title":"Bone Marrow Transplant"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.159343","article-title":"Minimal residual disease prior to allogeneic hematopoietic cell transplantation in acute myeloid leukemia: A meta-analysis","volume":"102","author":"Buckley","year":"2017","journal-title":"Haematologica"},{"key":"B9","volume-title":"United Kingdom; 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