Measurable residual disease intervention in AML: a new therapeutic horizon

Abstract

Acute myeloid leukemia (AML) is a polyclonal malignancy marked by high relapse rates despite initial morphologic remission. Although measurable residual disease (MRD) is an established prognostic tool, increasing evidence supports a role for preemptive, MRD-directed therapy. AML monitoring is hampered by the absence of a universal MRD marker, necessitating a more personalized approach. NPM1 is suited to an MRD-directed strategy because the mutation is AML defining and the monitoring methods are highly sensitive. Critically, rising NPM1mutlevels portend clinical relapse with high fidelity, and recent studies demonstrate that venetoclax-based regimens induce rapid and deep MRD responses in a h..