Comparison of flow cytometry and next‐generation sequencing in minimal residual disease monitoring of acute myeloid leukemia: One institute’s practical clinical experience

Abstract Introduction Monitoring patients with acute myeloid leukemia can be implemented through various techniques such as multiparameter flow cytometry, real‐time quantitative polymerase chain reaction, and next‐generation sequencing. However, there is scarce studies when comparing the data of next‐generation sequencing and flow cytometry for monitoring disease progression, particularly how they might supplement one another when used in tandem. Methods We investigated 107 patients via retrospective analysis using follow‐up MFC and NGS data with a total of 717 MFC and 247 NGS studies to compare these methods in monitoring minimal/measurable residual disease. Results 197 instances were MFC + /NGS + , 3 were MFC − /NGS − , 44 were MFC − /NGS + , and 3 are MFC + /NGS − . The majority of the MFC − /NGS + cases occurred within 6 months during the post‐treatment phase (64%). Among 44 MFC − /NGS + instances, 13 had similar NGS profiles to their original day 0 diagnosis. The remaining cases showed preleukemic clonal hematopoiesis mutations, “likely pathogenic mutations,” or “variants of uncertain significance.” Conclusion Our findings show that flow cytometry has its advantages with comparable sensitivity in detecting minimal/measurable residual disease. Next‐generation sequencing could be used in an increased and more regular capacity in conjunction with flow cytometry to achieve a more comprehensive surveillance of these patients, resulting in improved outcomes.