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Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblastic leukemia: results in 3184 patients of the AIE...

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Zeitschriftentitel: Blood
Personen und Körperschaften: Conter, Valentino, Bartram, Claus R., Valsecchi, Maria Grazia, Schrauder, André, Panzer-Grümayer, Renate, Möricke, Anja, Aricò, Maurizio, Zimmermann, Martin, Mann, Georg, De Rossi, Giulio, Stanulla, Martin, Locatelli, Franco, Basso, Giuseppe, Niggli, Felix, Barisone, Elena, Henze, Günter, Ludwig, Wolf-Dieter, Haas, Oskar A., Cazzaniga, Giovanni, Koehler, Rolf, Silvestri, Daniela, Bradtke, Jutta, Parasole, Rosanna, Beier, Rita, van Dongen, Jacques J. M., Biondi, Andrea, Schrappe, Martin
In: Blood, 115, 2010, 16, S. 3206-3214
Format: E-Article
Sprache: Englisch
veröffentlicht:
American Society of Hematology
Schlagwörter:
Cell Biology
Hematology
Immunology
Biochemistry
Details
Zusammenfassung: <jats:title>Abstract</jats:title> <jats:p>The Associazione Italiana di Ematologia Oncologia Pediatrica and the Berlin-Frankfurt-Münster Acute Lymphoblastic Leukemia (AIEOP-BFM ALL 2000) study has for the first time introduced standardized quantitative assessment of minimal residual disease (MRD) based on immunoglobulin and T-cell receptor gene rearrangements as polymerase chain reaction targets (PCR-MRD), at 2 time points (TPs), to stratify patients in a large prospective study. Patients with precursor B (pB) ALL (n = 3184) were considered MRD standard risk (MRD-SR) if MRD was already negative at day 33 (analyzed by 2 markers, with a sensitivity of at least 10−4); MRD high risk (MRD-HR) if 10−3 or more at day 78 and MRD intermediate risk (MRD-IR): others. MRD-SR patients were 42% (1348): 5-year event-free survival (EFS, standard error) is 92.3% (0.9). Fifty-two percent (1647) were MRD-IR: EFS 77.6% (1.3). Six percent of patients (189) were MRD-HR: EFS 50.1% (4.1; P &lt; .001). PCR-MRD discriminated prognosis even on top of white blood cell count, age, early response to prednisone, and genotype. MRD response detected by sensitive quantitative PCR at 2 predefined TPs is highly predictive for relapse in childhood pB-ALL. The study is registered at http://clinicaltrials.gov: NCT00430118 for BFM and NCT00613457 for AIEOP.</jats:p>
Umfang: 3206-3214
ISSN: 0006-4971
1528-0020
DOI: 10.1182/blood-2009-10-248146