CBFB::MYH11 MRD After the Second Chemotherapy Cycle: A Guide to Allogeneic Transplantation in Favorable-Risk AML

Overview

Acute myeloid leukemia (AML) with CBFB::MYH11 rearrangement is usually considered a favorable-risk subtype, meaning patients often respond well to initial chemotherapy. However, long-term outcomes are not uniformly excellent. Even in this group, relapse remains a major concern, with about 40% of patients eventually experiencing disease return. This study examined whether the level of measurable residual disease (MRD) based on CBFB::MYH11 transcript levels after early chemotherapy could better identify which patients need allogeneic hematopoietic cell transplantation (allo-HCT) in first complete remission (CR1).

The central question was practical and important: after induction chemotherapy, how can clinicians decide whether a patient with otherwise favorable-risk AML should continue with chemotherapy consolidation or move to transplant? The study suggests that MRD assessment after the second chemotherapy cycle may provide a more reliable guide than earlier or later measurements.