Post-Transplant Relapse in Acute Leukemia: Comparative Value of MRD and Chimerism.

No significant difference was observed at day 28 (p = 0.582), while month 3 MRD positivity showed a trend toward significance (66.7% vs 41.5%, p = 0.050).

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In contrast, among ALL patients, the presence of total-MC and MRD positivity at month 3 did not reach statistical significance for OS (p = 0.090 and p = 0.071, respectively) or DFS (p = 0.120 and p = 0.211, respectively) ( Figure 3 ).

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found that MRD positivity at day 100 was the strongest prognostic factor for relapse and survival, whereas mixed CD3 chimerism showed only borderline significance. 22 Similarly, Loke et al. demonstrated that MRD positivity after transplant conferred more than twice the hazard of death (HR ~2.2) and remained significant in multivariate analysis regardless of pre-transplant MRD status. 23 These concordant findings solidify post-HSCT MRD as a more robust and clinically relevant predictor of relapse than chimerism analysis.

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