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Clinical impact of minimal residual disease in children with different subtypes of acute lymphoblastic leukemia treated with Response-Adapted therapy.

Abstract：

:To determine the clinical significance of minimal residual disease (MRD) in patients with prognostically relevant subtypes of childhood acute lymphoblastic leukemia (ALL), we analyzed data from 488 patients treated in St Jude Total Therapy Study XV with treatment intensity based mainly on MRD levels measured during remission induction. MRD levels on day 19 predicted treatment outcome for patients with hyperdiploid >50 ALL, National Cancer Institute (NCI) standard-risk B-ALL or T-cell ALL, while MRD levels on day 46 were prognostic for patients with NCI standard-risk or high-risk B-ALL. Patients with t(12;21)/(ETV6-RUNX1) or hyperdiploidy >50 ALL had the best prognosis; those with a negative MRD on day 19 had a particularly low risk of relapse: 1.9% and 3.8%, respectively. Patients with NCI high-risk B-ALL or T-cell ALL had an inferior outcome; even with undetectable MRD on day 46, cumulative risk of relapse was 12.7% and 15.5%, respectively. Among patients with NCI standard-risk B-ALL, the outcome was intermediate overall but was poor if MRD was ⩾1% on day 19 or MRD was detectable at any level on day 46. Our results indicate that the clinical impact of MRD on treatment outcome in childhood ALL varies considerably according to leukemia subtype and time of measurement.

journal_name

Leukemia

journal_title

Leukemia

authors

Pui CH,Pei D,Raimondi SC,Coustan-Smith E,Jeha S,Cheng C,Bowman WP,Sandlund JT,Ribeiro RC,Rubnitz JE,Inaba H,Gruber TA,Leung WH,Yang JJ,Downing JR,Evans WE,Relling MV,Campana D

doi

10.1038/leu.2016.234

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

333-339

issue

2

eissn

0887-6924

issn

1476-5551

pii

leu2016234

journal_volume

31

pub_type

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