Low levels of minimal residual disease after induction chemotherapy for BCR‐ABL1‐negative acute lymphoblastic leukaemia in adults are clinically relevant

• Published in: British journal of haematology Vol. 196; no. 3; pp. 706 - 710
• Main Authors: Šálek, Cyril, Folber, František, Froňková, Eva, Pecherková, Pavla, Jelínková, Hana, Hrabovský, Štěpán, Horáček, Jan M., Cetkovský, Petr, Mayer, Jiří, Trka, Jan, Doubek, Michael
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.02.2022
• Subjects: acute lymphoblastic leukaemia; Acute lymphoblastic leukemia; Adult; Age Factors; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor; Central nervous system; Chemotherapy; Consolidation Chemotherapy; Disease Management; Female; Fusion Proteins, bcr-abl - genetics; Hematology; Humans; IG/TR rearrangements; Induction Chemotherapy; Leukemia; Male; Medical prognosis; Minimal residual disease; Multivariate analysis; Neoplasm, Residual - pathology; PCR; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality; Prognosis; prognostic factors; Proportional Hazards Models; Treatment Outcome; minimal residual disease; prognostic factors; IG/TR rearrangements; acute lymphoblastic leukaemia; PCR
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/bjh.17966

Summary The aim of the present study was to evaluate the significance of low‐level minimal/measurable residual disease (MRD) during early consolidation treatment in adult BCR‐ABL1–negative acute lymphoblastic leukaemia. The MRD load was monitored by immunoglobulin/T‐cell receptor rearrangements and assessed as negative [complete MRD response (CMR)], positive non‐quantifiable (MRDnq) and positive quantifiable (MRDq). MRDnq before the first and second consolidation blocks had a comparable negative effect on survival as MRDq. The 5‐year overall survival for CMR, MRDnq and MRDq at week 11 was 74·0%, 42·3% and 35·0% respectively. No central nervous system infiltration and MRD at week 11 were independent prognostic factors for survival on multivariate analysis (hazard ratios 0·32 and 2·25).