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

Br J Haematol. 2022 Feb;196(3):706-710. doi: 10.1111/bjh.17966. Epub 2021 Nov 23.

Abstract

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).

Keywords: IG/TR rearrangements; PCR; acute lymphoblastic leukaemia; minimal residual disease; prognostic factors.

MeSH terms

  • Adult
  • Age Factors
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor*
  • Consolidation Chemotherapy
  • Disease Management
  • Female
  • Fusion Proteins, bcr-abl / genetics*
  • Humans
  • Induction Chemotherapy
  • Male
  • Neoplasm, Residual / pathology*
  • 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
  • Proportional Hazards Models
  • Treatment Outcome

Substances

  • BCR-ABL1 fusion protein, human
  • Biomarkers, Tumor
  • Fusion Proteins, bcr-abl