Prognostic impact of early minimal residual disease combined with complete molecular evaluation in acute myeloid leukemia with mutated : a single center study.

We evaluated prognostic factors in 83 intensively treated adult patients with mutated AML. Targeted next-generation sequencing revealed high frequency of co-mutations in epigenetic modifiers or proliferation pathways. minimal residual disease (MRD), assessed in bone marrow by specific polymerase chain reaction after one chemotherapy course, was >0.01% in 50 patients considered poor responders (PR). On multivariate analysis, including all variables with a value <.1 on univariate analysis, age >60, performance status (PS) ≥1, presence of mutations, -R882, and PR status, were independently associated with lower leukemia-free survival. Age >60, a previous hematological disease and PR status were independent negative predictive factors for overall survival. In our study, early MRD was confirmed as an important prognostic factor. All and -R882 mutations have also an independent prognostic value. We support the rational for in-depth investigations for a better approach in patients who achieving a first complete remission.