Monitoring of minimal residual disease (MRD) is useful to predict prognosis of adult patients with Ph-negative ALL: results of a prospective study (ALL MRD2002 Study)

Autor: Yasunobu Abe, Masakazu Higuchi, Goichi Yoshimoto, Eiichi Ohtsuka, Tomohiko Kamimura, Shuichi Taniguchi, Shouhei Yokota, Koichi Akashi, Tetsuya Eto, Mine Harada, Koji Nagafuji, Tomoaki Fujisaki, Takashi Yoshida, Takashi Okamura, Toshihiro Miyamoto, Yasushi Takamatsu
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Oncology
Male
Cancer Research
Neoplasm
Residual
medicine.medical_treatment
Hematopoietic stem cell transplantation
Acute lymphoblastic leukemia
Polymerase Chain Reaction
Risk Factors
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
Medicine
Philadelphia Chromosome
Prospective Studies
Young adult
Prospective cohort study
Remission Induction
Combination chemotherapy
DNA
Neoplasm
Hematology
lcsh:Diseases of the blood and blood-forming organs
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Combined Modality Therapy
Survival Rate
Female
Adult
medicine.medical_specialty
Adolescent
lcsh:RC254-282
Young Adult
Internal medicine
Biomarkers
Tumor
Humans
Transplantation
Homologous
Survival rate
Molecular Biology
Chemotherapy
business.industry
lcsh:RC633-647.5
Gene Expression Profiling
Research
Minimal residual disease
Consolidation Chemotherapy
Surgery
business
Follow-Up Studies
Zdroj: Journal of Hematology & Oncology, Vol 6, Iss 1, p 14 (2013)
Journal of Hematology & Oncology
ISSN: 1756-8722
Popis: Background Allogeneic hematopoietic stem cell transplantation (HSCT) for patients with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) is much more intensive than multi-agent combined chemotherapy, although allogeneic HSCT is associated with increased morbidity and mortality when compared with such chemotherapy. Minimal residual disease (MRD) status has been proven to be a strong prognostic factor for adult patients with Ph-negative ALL. Methods We investigated whether MRD status in adult patients with ALL is useful to decide clinical indications for allogeneic HSCT. We prospectively monitored MRD after induction and consolidation therapy in adult patients with Ph-negative ALL. Results Of 110 adult ALL patients enrolled between July 2002 and August 2008, 101 were eligible, including 59 Ph-negative patients. MRD status was assessed in 43 patients by the detection of major rearrangements in TCR and Ig and the presence of chimeric mRNA. Thirty-nine patients achieved CR1, and their probabilities of 3-year overall survival and disease-free survival (DFS) were 74% and 56%, respectively. Patients who were MRD-negative after induction therapy (n = 26) had a significantly better 3-year DFS compared with those who were MRD-positive (n = 13; 69% vs. 31%, p = 0.004). All of 3 patients who were MRD-positive following consolidation chemotherapy and did not undergo allogeneic HSCT, relapsed and died within 3 years after CR. Conclusions These results indicate that MRD monitoring is useful for determining the clinical indications for allogeneic HSCT in the treatment of ALL in CR1.
Databáze: OpenAIRE
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