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Minimal residual disease in BCR::ABL1-positive acute lymphoblastic leukemia: different significance in typical ALL and in CML-like disease
J. Zuna, L. Hovorkova, J. Krotka, A. Koehrmann, M. Bardini, L. Winkowska, E. Fronkova, J. Alten, R. Koehler, C. Eckert, L. Brizzolara, M. Trkova, J. Stuchly, M. Zimmermann, P. De Lorenzo, MG. Valsecchi, V. Conter, J. Stary, M. Schrappe, A....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, práce podpořená grantem
NLK
ProQuest Central
od 2000-01-01 do Před 1 rokem
Open Access Digital Library
od 1997-01-01
Nursing & Allied Health Database (ProQuest)
od 2000-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2000-01-01 do Před 1 rokem
Public Health Database (ProQuest)
od 2000-01-01 do Před 1 rokem
- MeSH
- akutní lymfatická leukemie * genetika farmakoterapie MeSH
- akutní nemoc MeSH
- bcr-abl fúzové proteiny genetika MeSH
- chronická myeloidní leukemie * farmakoterapie genetika MeSH
- dítě MeSH
- lidé MeSH
- retrospektivní studie MeSH
- reziduální nádor genetika MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Recently, we defined "CML-like" subtype of BCR::ABL1-positive acute lymphoblastic leukemia (ALL), resembling lymphoid blast crisis of chronic myeloid leukemia (CML). Here we retrospectively analyzed prognostic relevance of minimal residual disease (MRD) and other features in 147 children with BCR::ABL1-positive ALL (diagnosed I/2000-IV/2021, treated according to EsPhALL (n = 133) or other (n = 14) protocols), using DNA-based monitoring of BCR::ABL1 genomic breakpoint and clonal immunoglobulin/T-cell receptor gene rearrangements. Although overall prognosis of CML-like (n = 48) and typical ALL (n = 99) was similar (5-year-EFS 60% and 49%, respectively; 5-year-OS 75% and 73%, respectively), typical ALL presented more relapses while CML-like patients more often died in the first remission. Prognostic role of MRD was significant in the typical ALL (p = 0.0005 in multivariate analysis for EFS). In contrast, in CML-like patients MRD was not significant (p values > 0.2) and inapplicable for therapy adjustment. Moreover, in the typical ALL, risk-prediction could be further improved by considering initial hyperleukocytosis. Early distinguishing typical BCR::ABL1-positive ALL and CML-like patients is essential to enable optimal treatment approach in upcoming protocols. For the typical ALL, tyrosine-kinase inhibitors and concurrent chemotherapy with risk-directed intensity should be recommended; in the CML-like disease, no relevant prognostic feature applicable for therapy tailoring was found so far.
Centre for Medical Genetics and Reproductive Medicine GENNET Prague Czech Republic
Charité Universitätsmedizin Berlin Berlin Germany
Department of Human Genetics University Hospital Heidelberg Heidelberg Germany
Department of Pediatric Hematology and Oncology Medical School Hannover Hannover Germany
EsPhALL Trial Data Center School of Medicine and Surgery University of Milano Bicocca Monza Italy
Medical Genetics School of Medicine and Surgery University of Milano Bicocca Monza Italy
Pediatric Hemato Oncolgy Fondazione MBBM ASST Monza University of Milano Bicocca Monza Italy
Pediatrics University Hospital Schleswig Holstein Campus Kiel Kiel Germany
Tettamanti Research Center Pediatrics University of Milano Bicocca Fondazione Tettamanti Monza Italy
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