Molecular MRD as measured by digital PCR offers key insights into AML biology and therapy response

Adults with acute myeloid leukemia (AML) typically require multi-agent chemotherapy with or without hematopoietic stem cell transplant (HSCT) for a chance at a cure. Pathologic evaluation of disease response has historically provided only a limited predictive value of a patient’s relapse risk and chances of long-term survival. Measurable residual disease (MRD) has emerged as a more sensitive tool for detecting resistant AML and a more accurate predictor of outcomes. Still, currently, clinical MRD based on flow cytometry only detects a subset of patients whose disease will ultimately recur.

MRD based on a patient’s specific AML-associated mutations is predicted to supplement flow cytometry MRD to predict outcomes better. We have utilized digital PCR (dPCR) to detect low-level AML mutations in remission bone marrow samples from AML patients on various therapies. dPCR MRD is predictive of relapse risk and overall survival and allows us to infer patterns in disease evolution in response to therapy.

About the speaker

Amanda C. Winters, MD, PhD, Assistant Professor

University of Colorado

Dr. Amanda Winters is an Assistant Professor of Pediatrics at the University of Colorado and Children's Hospital Colorado. As a clinician, she treats children and adolescents diagnosed with leukemias and lymphomas. Her primary research focuses on developing high-sensitivity mutation-based measurable residual disease assays for children and adults with acute myeloid leukemia. She is also interested in preclinical validation of candidate targeted therapies to improve outcomes in pediatric AML.