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)

Journal of Hematology & Oncology

Mine Harada^1,13  Koichi Akashi²  Shouhei Yokota⁹  Yasushi Takamatsu⁷  Yasunobu Abe^1,10  Tomoaki Fujisaki³  Goichi Yoshimoto⁴  Masakazu Higuchi⁵  Takashi Yoshida^1,12  Eiichi Ohtsuka¹  Takashi Okamura^1,14  Shuichi Taniguchi⁸  Tomohiko Kamimura^1,11  Tetsuya Eto⁶  Toshihiro Miyamoto²  Koji Nagafuji^1,14 

[1] Department of Hematology, Oita Prefectural Hospital, Oita, Japan;Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan;Department of Hematology, Matsuyama Red Cross Hospital, Ehime, Japan;Department of Hematology, Kyushu Medical Center, Fukuoka, Japan;Department of Hematology, Kyushu Kosei-Nenkin Hospital, Kitakyushu, Japan;Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan;Department of Oncology Hematology, Fukuoka University Hospital, Fukuoka, Japan;Department of Hematology, Toranomon Hospital, Tokyo, Japan;Department of Hematology, Kyoto Prefectural University of Medicine, Kyoto, Japan;Department of Medicine and Bioregulatory Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan;Department of Hematology, HaraSanshin General Hospital, Fukuoka, Japan;Department of Hematology, Toyama Prefectural Central Hospital, Toyama, Japan;Medical Center for Karatsu Higashimatuura Medical Association, Karatsu, Japan;Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan

关键词: Adult;    Hematopoietic stem cell transplantation;    Minimal residual disease;    Acute lymphoblastic leukemia;   

Others  :  812621
DOI  :  10.1186/1756-8722-6-14

 received in 2012-12-27, accepted in 2013-02-03,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Nagafuji et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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