Longitudinal ultra-sensitive mutation burden sequencing for precise minimal residual disease assessment in AML

作者：Yitian Wu, Shuai Zhang, Ru Feng, Kang-Wen Xiao, Ting Wang, Jiefei Bai, Xiaoyu Zhou, Yuji Wang, Peng Dai, Hui Liu, Lucia R. Wu · 发表于：Nature Communications · 年份：2024 · DOI：10.1038/s41467-024-54254-6 · 被引用次数：9 · 研究领域：Acute Myeloid Leukemia Research、Protein Degradation and Inhibitors、Cancer Genomics and Diagnostics

Relapse is one of the major challenges in clinical treatment of acute myeloid leukemia (AML). Though minimal residual disease (MRD) monitoring plays a crucial role in quantitative assessment of the disease, molecular MRD analysis has been mainly limited to patients diagnosed with gene fusions and NPM1 mutations. Here, we report a longitudinal ultra-sensitive mutation burden (UMB) monitoring strategy for accurate MRD analysis in AML patients regardless of genetic abnormality types. Using a Quantitative Blocker Displacement Amplification (QBDA) sequencing panel with limit of detection below 0.01% variant allele frequency (VAF), a hazard ratio of 14.8 (p < 0.001) is observed in cumulative incidence of relapse analysis of 20 patients with ≥ 2 samples during complete remission (CR). The ROC area under curve (AUC) is 0.98 when predicting relapse within 30 weeks of CR timepoint 2 (N = 20). Furthermore, we demonstrate quantitating VAF below 0.01% is essential for accurate relapse prediction. Monitoring of minimal residual disease is a key method for detecting potential acute myeloid leukaemia relapse. Here, the authors developed a longitudinal mutation burden monitoring strategy using ultra-sensitive mutation sequencing to quantitate VAF below 0.01% for accurate minimal residual disease assessment and relapse prediction.