Our latest data 6 again showed the additional value of LSC detection for risk classification a single
parameter and in combination with standard MRD. To facilitate the use of this tube for clinical
evaluation, we prepared a standardized protocol 8, which now has been successfully performed in
7 other institutes (manuscript submitted).
Still new stem cell markers are being discovered such as TARP 9 and GRP56 10 and the advantage
of the chosen principle of our tube is that more markers can be added in the combination channel
when they have proven beneficial. In addition, CD markers can also be taken out of the combination
channel and measured separately if they are for instance target of novel treatment strategies such
as CLEC12A.
In general, relatively high levels of LSC present at diagnosis is already a very strong prognostic factor
for relapse. LSC persistence during therapy is more challenging to measure due to very low
frequencies but is instrumental in selecting patients at very high risk of relapse.
References:
1. Döhner H, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an
international expert panel. Blood. 2017;129(4):424-447.
2. Bewersdorf JP, et al. The minimal that kills: Why defining and targeting measurable residual disease
is the "Sine Qua Non" for further progress in management of acute myeloid leukemia. Blood Rev.
2019 In press.
3. Thomas D & Majeti R. Biology and relevance of human acute myeloid leukemia stem cells. Blood.
2017 Mar 23;129(12):1577-1585.
4. Chopra M, Bohlander SK. The cell of origin and the leukemia stem cell in acute myeloid leukemia.
Genes Chromosomes Cancer. 2019 Dec;58(12):850-858.
5. Terwijn M, et al. Leukemic stem cell frequency: a strong biomarker for clinical outcome in acute
myeloid leukemia. PLoS One. 2014;9(9):e107587.
6. Zeijlemaker W, et al. CD34(+)CD38(-) leukemic stem cell frequency to predict outcome in acute
myeloid leukemia. Leukemia. 2019;33(5):1102-1112.
7. Hanekamp D, et al. Leukaemic stem cell load at diagnosis predicts the development of relapse in
young acute myeloid leukaemia patients. Br J Haematol. 2018;183(3):512-516.
8. Cloos J, et al. Comprehensive Protocol to Sample and Process Bone Marrow for Measuring
Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia. J Vis Exp.
2018;(133).
9. Depreter B, et al. TARP is an immunotherapeutic target in acute myeloid leukemia expressed in the
leukemic stem cell compartment. Haematologica. 2019 In press.
10. Jentzsch M, et al. High expression of the stem cell marker GPR56 at diagnosis identifies acute myeloid
leukemia patients at higher relapse risk after allogeneic stem cell transplantation in context with the
CD34+/CD38- population. Haematologica. 2020 In press.
SCIENTIFIC
PROGRAMME
RARE SUBSETS OF
ACUTE LEUKAEMIA
TRACKING LEUKAEMIC
STEM CELLS (LSCs)
ROUTINE DIAGNOSIS
GENE EXPRESSION
AND MUTATIONAL
PROFILING
DEBATE 1 – ALL
PATIENTS WITH
INTERMEDIATE-RISK
AML MUST BE
TRANSPLANTED
INTERACTIVE
CASES 1 – MUTATION-BASED
THERAPY
OFF-LABEL
ROUNDTABLE –
SHOULD WE REALLY
USE NEW TARGETED
INHIBITORS AS SINGLE
AGENTS ?
ADDITION OF A 3RD
AGENT TO FRONTLINE
7+3
ROUNDTABLE –
CURATIVE OPTIONS
FOR OLDER AML
INTERACTIVE CASES 2
DEBATE 2 - BEST
TREATMENT FOR
NPM1-MUTATED AML IN
THE NEXT FUTURE ?
ALLOGENEIC
HAEMATOPOIETIC
STEM CELL
TRANSPLANTATION
(HSCT)
IMMUNOTHERAPY FOR
ACUTE LEUKAEMIA
DEBATE 3 - T-ALL:
WHERE ARE WE GOING
NOW?
SELECTED ABSTRACTS
AND CLINICAL
CASES FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES