Regular monitoring using a sensitive bone marrow test can significantly improve survival of some younger adults with acute myeloid leukaemia (AML), British researchers have reported.
The trial, reported in The Lancet Haematology, found that minimal residual disease (MRD) testing every three months led to a 50% improvement in overall survival among patients with both NPM1 mutations and FLT3 internal tandem duplications (FLT3-ITD).
The study involved 637 patients aged between 16 and 60, taking part in two trials between 2012 and 2018. The patients were in remission from AML and received either standard clinical monitoring or regular bone marrow tests every three months.
MRD monitoring did not improve survival for the group overall, but the pre-specified patient group with both NPM1 mutations and FLT3-ITD, which made up 22% of the cohort, saw a significant improvement in overall survival compared to standard care.
The researchers, led by a team from King’s College London, are now working with the NHS to encourage the use of testing across the UK.
The trial was funded by Blood Cancer UK, Cancer Research UK, and the NIHR, and was sponsored by Cardiff University.
Researcher Dr Richard Dillon from King’s said: “Knowing early that a patient’s cancer is going to relapse is crucial for planning their treatment. We hope that these tests become part of routine care for this type of cancer across the UK and worldwide, and ultimately improve long-term survival rates for patients.”
Fellow researcher Professor Nigel Russell, consultant at Guy’s and St Thomas’ NHS Foundation Trust, said: “There is still so much to learn about how best to treat this fast-moving form of cancer. We hope our research offers a new approach to detecting if a patient is at risk of relapse and offers hope to patients suffering from this disease.”
Professor Marian Knight, scientific director for NIHR Infrastructure and Director of NIHR Programme Grants for Applied Research, said: “Early detection of the potential for relapse of any cancer is essential to ensure people can restart or change treatment quicker and improve their long-term survival rate.”
Source:
Potter N, Jovanovic J, Ivey A, Othman J, Thomas A, Gilkes A, Runglall M, Kanda A, Thomas I, Johnson S, Canham J, Villiers W, Knapper S, Khwaja A, McMullin MF, Cavenagh J, Overgaard UM, Clark RE, Solomon E, Freeman SD, Hills R, Burnett A, Russell N, Dillon R, on behalf of the UK AML Research Network. (2025) “Molecular monitoring versus standard clinical care in younger adults with acute myeloid leukaemia: results from the UK NCRI AML17 and AML19 randomised, controlled, phase 3 trials.” Lancet Haematology, May 2025, doi: 10.1016/S2352-3026(25)00037-7.
Link: https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(25)00037-7/fulltext
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