Measurable residual disease-guided interventions in patients with acute myeloid leukaemia undergoing allogeneic haematopoietic cell transplantation: best practice recommendations from the European Society for Blood and Marrow Transplantation Practice Harmonisation and Guidelines Committee
Sanz, Jaime Bug, Gesine Ciceri, Fabio Craddock, Charles Dillon, Richard Esteve, Jordi Porta, Matteo Giovanni Della Heuser, Michael de Leeuw, David C Nagler, Arnon
Sanz, Jaime
Bug, Gesine
Ciceri, Fabio
Craddock, Charles
Dillon, Richard
Esteve, Jordi
Porta, Matteo Giovanni Della
Heuser, Michael
de Leeuw, David C
Nagler, Arnon
Affiliation
Hospital Universitari i Politècnic La Fe; Universitat de Valencia; Goethe University; German Cancer Consortium; German Cancer Research Center; Vita-Salute San Raffaele University; IRCCS San Raffaele Scientific Institute; University of Warwick; University Hospitals Birmingham NHS Foundation Trust; Guy's and St Thomas' NHS Foundation Trust; King's College London; University of Barcelona; Hospital Clínic of Barcelona; Humanitas University Milan; Hannover Medical School; University Hospital Halle; Martin-Luther-University Halle-Wittenberg; Amsterdam University Medical Centers; Sheba Medical Center; Tel Aviv University; University of Milan; New York Presbyterian Hospital; Weill Cornell Medicine; EBMT Executive Office; Centre Hospitalier Universitaire de Lille; University of Lille; University Tor Vergata of Rome
Other Contributors
Publication date
2025-11
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Measurable residual disease (MRD) is a key predictor of relapse, the primary cause of treatment failure after allogeneic haematopoietic cell transplantation (allo-HCT) in acute myeloid leukaemia. This Policy Review, based on guidance from the European Society for Blood and Marrow Transplantation, provides practical recommendations for incorporating MRD assessment into clinical decision making during the transplantation process, the application of which remains challenging in acute myeloid leukaemia due to technical limitations and the limited availability of standardised, evidence-based approaches. Available methods include reverse transcription quantitative PCR, digital droplet PCR, next-generation sequencing, and multiparametric flow cytometry-chimerism-based approaches are under investigation. This Policy Review highlights the importance of MRD monitoring to enable timely, risk-adapted interventions that encompass both pre-transplantation and post-transplantation periods and can include tailoring conditioning intensity, donor selection, immunosuppression management, donor lymphocyte infusions, and pharmacological therapies such as FLT3 or IDH inhibitors, hypomethylating agents, venetoclax, or menin inhibitors. These recommendations aim to harmonise MRD-driven clinical practice and improve patient outcomes, while identifying key areas for future research.
Citation
Sanz J, Bug G, Ciceri F, Craddock C, Dillon R, Esteve J, Porta MGD, Heuser M, de Leeuw DC, Nagler A, Onida F, Roboz GJ, Ruggeri A, Sánchez-Ortega I, Srour M, Yakoub-Agha I, Buccisano F. Measurable residual disease-guided interventions in patients with acute myeloid leukaemia undergoing allogeneic haematopoietic cell transplantation: best practice recommendations from the European Society for Blood and Marrow Transplantation Practice Harmonisation and Guidelines Committee. Lancet Oncol. 2025 Nov;26(11):e586-e596. doi: 10.1016/S1470-2045(25)00426-7.
Type
Article