Innovative Leukemia Stem Cell Technique Enhances Relapse Prediction in AML Patients
A groundbreaking leukemia stem cell-based assay improves relapse prediction accuracy in AML patients, outperforming traditional methods and enabling better post-transplant management.
A recent study has demonstrated that an assay utilizing leukemia stem cells (LSCs) can significantly improve the prediction of disease relapse in patients with acute myeloid leukemia (AML). This LSC-based method outperforms the traditional multiparameter flow cytometry (MFC) approaches, offering a more accurate tool to assess measurable residual disease (MRD). The research, published online on August 23, 2025, in Bone Marrow Transplantation, involves an in-depth analysis of 360 AML patients who underwent allogeneic transplantation between July 2018 and November 2019.
In the study, Si-Qi Li from Peking University People's Hospital and colleagues examined the predictive power of the LSC-based assay compared to conventional MFC-MRD testing. They found that patients with positive MRD based on CD34+CD38− cocktail+ LSCs (≥0.004%) exhibited a substantially higher five-year cumulative relapse incidence (49.7%) compared to those with lower levels (8.5%). These patients also showed worse leukemia-free survival (48.2% vs. 84.4%) and overall survival rates (59.7% vs. 82.8%).
Similarly, traditional MFC-MRD detection was associated with increased relapse risk and decreased survival, but the LSC-based assay demonstrated superior sensitivity and accuracy. The median interval from LSC positivity to relapse was also longer (144 days) compared to traditional MRD markers (65 days), providing a valuable window for intervention.
The findings suggest that incorporating LSC-based MRD assessment could enhance relapse prediction and management strategies for AML patients post-transplant. The authors advocate for the adoption of this method in clinical practice, supported by long-term follow-up data and its high performance metrics, such as a C-index of 0.72 and Youden index of 0.44.
Overall, this advancement represents a promising step forward in AML treatment, helping clinicians better identify high-risk patients and tailor post-treatment strategies accordingly.
For more details, see the original study: Si-Qi Li et al., Leukemia stem cells for relapse prediction in AML patients receiving allografts: long-term follow-up of a prospective study, Bone Marrow Transplantation (2025). DOI: 10.1038/s41409-025-02699-8
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