Minimal residual disease is an independent predictor for 10-year survival in CLL.

Abstract:

:Minimal residual disease (MRD) negativity, defined as <1 chronic lymphocytic leukemia (CLL) cell detectable per 10 000 leukocytes, has been shown to independently predict for clinical outcome in patients receiving combination chemoimmunotherapy in the frontline setting. However, the long-term prognostic value of MRD status in other therapeutic settings remains unclear. Here, we retrospectively analyzed, with up to 18 years follow-up, all patients at our institution who achieved at least a partial response (PR) with various therapies between 1996 and 2007, and received a bone marrow MRD assessment at the end of treatment according to the international harmonized approach. MRD negativity correlated with both progression-free survival (PFS) and overall survival (OS) independent of the type and line of treatment, as well as known prognostic factors including adverse cytogenetics. The greatest impact of achieving MRD negativity was seen in patients receiving frontline treatment, with 10-year PFS of 65% vs 10% and 10-year OS of 70% vs 30% for MRD-negative vs MRD-positive patients, respectively. Our results demonstrate the long-term benefit of achieving MRD negativity, regardless of the therapeutic setting and treatment modality, and support its use as a prognostic marker for long-term PFS and as a potential therapeutic goal in CLL.

journal_name

Blood

journal_title

Blood

authors

Kwok M,Rawstron AC,Varghese A,Evans PA,O'Connor SJ,Doughty C,Newton DJ,Moreton P,Hillmen P

doi

10.1182/blood-2016-05-714162

subject

Has Abstract

pub_date

2016-12-15 00:00:00

pages

2770-2773

issue

24

eissn

0006-4971

issn

1528-0020

pii

blood-2016-05-714162

journal_volume

128

pub_type

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