Cell-free DNA 5-hydroxymethylcytosine is highly sensitive for MRD assessment in acute myeloid leukemia

Measurable residual disease (MRD) is an important biomarker in acute myeloid leukemia (AML). However, MRD cannot be detected in many patients using current methods. We developed a highly sensitive 5-hydroxymethylcytosine (5hmC) signature in cell-free DNA by analyzing 115 AML patients and 86 controls. The 5hmC method detected MRD in 20 of 29 patients with negative MRD by multiparameter flow cytometry and 11 of 14 patients with negative MRD by molecular methods. MRD detection by the 5hmC method was significantly associated with relapse-free survival. This novel method can be used in most AML patients and may significantly impact AML patient management.

Automated summary

Measurable residual disease (MRD) is an important biomarker in acute myeloid leukemia (AML), but current methods cannot detect MRD in many patients. We developed a highly sensitive 5-hydroxymethylcytosine (5hmC) signature in cell-free DNA that can detect MRD in AML patients with negative MRD by other methods. This novel method is significantly associated with relapse-free survival and may greatly impact AML patient management.