Are measurable residual disease results after consolidation therapy useful in children with acute lymphoblastic leukemia?

Autor: Stutterheim J; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. j.stutterheim@prinsesmaximacentrum.nl., van der Waarden R; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands., de Groot-Kruseman HA; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.; Dutch Childhood Oncology Group (DCOG), Utrecht, The Netherlands., Sonneveld E; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.; Dutch Childhood Oncology Group (DCOG), Utrecht, The Netherlands., de Haas V; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.; Dutch Childhood Oncology Group (DCOG), Utrecht, The Netherlands., Dandis R; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands., van der Schoot CE; Department of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands., van der Velden VHJ; Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Pieters R; Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.; Dutch Childhood Oncology Group (DCOG), Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Leukemia [Leukemia] 2024 Nov; Vol. 38 (11), pp. 2376-2381. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1038/s41375-024-02386-5
Abstrakt: Measurable residual disease (MRD) is regularly tested at later timepoints after the end of first consolidation (EOC) in children with acute lymphoblastic leukemia (ALL). The question remains whether this is useful for detecting (molecular) relapse. We investigated the clinical relevance of MRD after EOC in intermediate risk patients treated on DCOG-ALL-10 (n = 271) and DCOG-ALL-9 (n = 122), with MRD <0.05% at EOC. EOC MRD-negative patients (n = 178) had excellent outcomes, irrespective of MRD results at later timepoints; 6-year cumulative incidence of relapse (6-y CIR) of 7.4% (95% CI, 3.9%-12.3%) for those with MRD negativity at all later timepoints compared to 3.8% (95% CI, 0.3%-16.8%) for those with one or more later timepoints being positive (p = 0.51). Patients with positive EOC MRD (n = 91) of whom the subsequent timepoints were MRD negative (n = 43), had comparable good outcomes, 6-y CIR of 7.0% (95% CI, 1.8%-17.2%). In contrast, patients being MRD positive at EOC and MRD positive at one or more subsequent timepoints (n = 48) had a higher risk of relapse, 6-y CIR 29.4% (95% CI, 17.2%-42.8%), p < 0.001. These findings were confirmed in the validation cohort of ALL-9 as well as using the updated EuroMRD guidelines. In EOC MRD-negative patients, subsequent MRD measurements can be abandoned. For EOC MRD-positive patients the subsequent MRD measurement might be informative for further risk stratification.
(© 2024. The Author(s).)
Databáze: MEDLINE
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