{
  "abstract": "Purpose: To evaluate the prognostic value of integrated post-transplant monitoring of NGS-based measurable residual disease (MRD) and donor chimerism in older patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS), undergoing reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT).\n\nMaterials and methods: This retrospective study analyzed the clinical outcomes of 113 patients with AML or MDS, aged ≥ 60 years or ≥ 55 years if deemed unfit for standard-intensity conditioning, who underwent RIC allo-SCT. NGS-based MRD testing and donor chimerism were assessed at 3 months post-transplant.\n\nResults: A total of 113 patients participated in the study (median age 63 years; 69.9% with AML); among the 105 patients evaluable at 3 months post-transplantation, MRD positivity occurred in 28 patients (26.7%) and predicted inferior overall survival (hazard ratio [HR] 6.373, 95% confidence interval [CI] 3.005–13.517; P < 0.001), while complete donor chimerism (CDC), achieved in 82 patients (78.1%), predicted improved survival (HR 0.356, 95% CI 0.195–0.916; P = 0.028). MRD positivity remained an independent predictor of survival on multivariate analysis (HR 3.315, 95% CI 1.423–7.230, P = 0.005), while CDC showed a trend toward improved survival that did not reach statistical significance (HR 0.494, 95% CI 0.306–1.009, P = 0.051). Two-year overall survival differed markedly across the four MRD/CDC subgroups, ranging from 85.6% [MRD(–)/CDC( +)] to 13.6% [MRD( +)/CDC(–)] (P < 0.001), with the MRD( +)/CDC(–) group showing the highest 2-year relapse incidence (69.7%).\n\nConclusion: The combination of NGS-based MRD and chimerism monitoring is a critical prognostic strategy for older patients with AML/MDS undergoing RIC allo-SCT. Early identification of MRD positivity or mixed chimerism allows timely, risk-adapted interventions, including donor lymphocyte infusion, hypomethylating agents, and targeted therapies to reduce relapse and improve survival.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s44313-026-00187-6.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-Ro, Wonmi-Gu, Bucheon, 14584 Republic of Korea",
    "Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401 Korea"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Se Hyung Kim",
      "orcid": "0000-0002-3426-1191"
    },
    {
      "affs": [
        0
      ],
      "name": "Jina Yun",
      "orcid": "0000-0001-5897-8309"
    },
    {
      "affs": [
        1
      ],
      "name": "Kyoung Ha Kim",
      "orcid": "0000-0001-8842-4761"
    },
    {
      "affs": [
        1
      ],
      "name": "Seug Yun Yoon",
      "orcid": "0000-0001-8228-0218"
    },
    {
      "affs": [
        0
      ],
      "name": "Chan Kyu Kim",
      "orcid": "0000-0002-1517-9950"
    },
    {
      "affs": [
        0
      ],
      "name": "Seong Kyu Park",
      "orcid": "0000-0002-3055-3621"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/egps0dmqt4nvp.bib",
  "cited_by": 0,
  "doi": "10.1007/s44313-026-00187-6",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710518/",
  "id": "egps0dmqt4nvp",
  "issns": [
    "2287-979X",
    "2288-0011"
  ],
  "landing_url": "https://doi.org/10.1007/s44313-026-00187-6",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7223653365",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s44313-026-00187-6.pdf",
  "pmcid": "PMC13710518",
  "pmid": "42931992",
  "published": "2026-10-26",
  "publisher": "Springer",
  "ris": "https://research.draconitic.com/paper/egps0dmqt4nvp.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:28Z",
      "native_id": "PMC13710518",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s44313-026-00187-6"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Hematopoietic Stem Cell Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Post-transplant monitoring of NGS-based measurable residual disease and donor chimerism as a prognostic tool in older patients with AML/MDS",
  "title_text": "Post-transplant monitoring of NGS-based measurable residual disease and donor chimerism as a prognostic tool in older patients with AML/MDS",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:28Z",
  "url": "https://research.draconitic.com/paper/egps0dmqt4nvp",
  "venue": "Blood Research",
  "versions": []
}