Minimal residual disease after induction is the strongest predictor of prognosis in intermediate risk relapsed acute lymphoblastic leukaemia – Long-term results of trial ALL-REZ BFM P95/96

2013 ◽  
Vol 49 (6) ◽  
pp. 1346-1355 ◽  
Author(s):  
Cornelia Eckert ◽  
Arend von Stackelberg ◽  
Karl Seeger ◽  
Tom W.L. Groeneveld ◽  
Christina Peters ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Minimal Residual Disease ◽  
Lymphoblastic Leukaemia ◽  
Residual Disease ◽  
Long Term Results ◽  
Intermediate Risk ◽  
Minimal Residual

Excellent outcome of minimal residual disease-defined low-risk patients is sustained with more than 10 years follow-up: results of UK paediatric acute lymphoblastic leukaemia trials 1997–2003

2016 ◽  
Vol 101 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Jack Bartram ◽  
Rachel Wade ◽  
Ajay Vora ◽  
Jeremy Hancock ◽  
Chris Mitchell ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Minimal Residual Disease ◽  
Induction Chemotherapy ◽  
Lymphoblastic Leukaemia ◽  
Residual Disease ◽  
Low Risk ◽  
Excellent Outcome ◽  
Minimal Residual

BackgroundMinimal residual disease (MRD) is defined as the presence of sub-microscopic levels of leukaemia. Measurement of MRD from bone marrow at the end of induction chemotherapy (day 28) for childhood acute lymphoblastic leukaemia (ALL) can highlight a large group of patients (>40%) with an excellent (>90%) short-term event-free survival (EFS). However, follow-up in recent published trials is relatively short, raising concerns about using this result to infer the safety of further therapy reduction in the future.MethodsWe examined MRD data on 225 patients treated on one of three UKALL trials between 1997 and 2003 to assess the long-term (>10 years follow-up) outcome of those patients who had low-risk MRD (<0.01%) at day 28.ResultsOur pilot data define a cohort of 53% of children with MRD <0.01% at day 28 who have an EFS of 91% and long-term overall survival of 97%. Of 120 patients with day-28 MRD <0.01% and extended follow-up, there was one death due to treatment-related toxicity, one infectious death while in complete remission, and four relapse deaths.ConclusionsThe excellent outcome for childhood ALL in patients with MRD <0.01% after induction chemotherapy is sustained for more than 10 years from diagnosis. This supports the potential exploration of further reduction of therapy in this group, in an attempt to reduce treatment-related mortality and late effects.

Flow cytometric minimal residual disease assessment of peripheral blood in acute lymphoblastic leukaemia patients has potential for early detection of relapsed extramedullary disease

2018 ◽  
Vol 71 (7) ◽  
pp. 653-658 ◽  
Author(s):  
Alissa Keegan ◽  
Karry Charest ◽  
Ryan Schmidt ◽  
Debra Briggs ◽  
Daniel J Deangelo ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Minimal Residual Disease ◽  
Lymphoblastic Leukaemia ◽  
Peripheral Blood ◽  
Residual Disease ◽  
Diagnostic Value ◽  
Disease Assessment ◽  
Extramedullary Disease ◽  
Systemic Relapse ◽  
Minimal Residual

ObjectivesTo evaluate peripheral blood (PB) for minimal residual disease (MRD) assessment in adults with acute lymphoblastic leukaemia (ALL).MethodsWe analysed 76 matched bone marrow (BM) aspirate and PB specimens independently for the presence of ALL MRD by six-colour flow cytometry (FC).ResultsThe overall rate of BM MRD-positivity was 24% (18/76) and PB was also MRD-positive in 22% (4/18) of BM-positive cases. We identified two cases with evidence of leukaemic cells in PB at the time of the extramedullary relapse that were interpreted as MRD-negative in BM.ConclusionsThe use of PB MRD as a non-invasive method for monitoring of systemic relapse may have added clinical and diagnostic value in patients with high risk of extramedullary disease.

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