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Monitoring minimal residual disease in children with high-risk relapses of acute lymphoblastic leukemia: prognostic relevance of early and late assessment

Eckert, C
Author Eckert, C Department of Pediatric Oncology/Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany
Hagedorn, N
Author Hagedorn, N Department of Pediatric Oncology/Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany
Sramkova, L
Author Sramkova, L ] Department of Pediatric Hematology and Oncology, Charles University, 2nd Medical School and University Hospital Motol, Prague, Czech Republic [2] CLIP - Childhood Leukemia Investigation Prague, Prague, Czech Republic
Mann, G
Author Mann, G St Anna Children's Research Institute and Children's Hospital, Medical University of Vienna, Vienna, Austria
Panzer-Grümayer, R
Author Panzer-Grümayer, R St Anna Children's Research Institute and Children's Hospital, Medical University of Vienna, Vienna, Austria
Peters, C
Author Peters, C ORCID St Anna Children's Research Institute and Children's Hospital, Medical University of Vienna, Vienna, Austria
Bourquin, J-P
Author Bourquin, J-P Department of Pediatric Oncology, University Children's Hospital, Zurich, Switzerland
Klingebiel, T
Author Klingebiel, T Hospital for Children and Adolescents, Goethe-University Hospital Frankfurt, Frankfurt, Germany
Borkhardt, A
Author Borkhardt, A ORCID Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University, Duesseldorf, Germany
Cario, G
Author Cario, G Department of Pediatrics, University of Schleswig-Holstein, Kiel, Germany
Alten, J
Author Alten, J Department of Pediatrics, University of Schleswig-Holstein, Kiel, Germany
Escherich, G
Author Escherich, G Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Astrahantseff, K
Author Astrahantseff, K Department of Pediatric Oncology/Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany
Seeger, K
Author Seeger, K Department of Pediatric Oncology/Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany
Henze, G
Author Henze, G Department of Pediatric Oncology/Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany
von Stackelberg, A
Author von Stackelberg, A Department of Pediatric Oncology/Hematology, Charité Universitätsmedizin Berlin, Berlin, Germany

Leukemia. 2015 Aug ; 29 (8) : 1648-55. [epub] 20150309

ISSN 1476-5551 | 0887-6924
Source

Language English Country Great Britain, England Media print-electronic

Document type Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't

Persistent link https://www.medvik.cz/link/pmid25748682

PubMed 25748682
DOI 10.1038/leu.2015.59
PII: leu201559
Knihovny.cz E-resources

MeSH
Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy mortality pathology MeSH
Child MeSH
Induction Chemotherapy MeSH
Humans MeSH
Neoplasm Recurrence, Local drug therapy mortality pathology MeSH
Survival Rate MeSH
Adolescent MeSH
Monitoring, Physiologic * MeSH
Follow-Up Studies MeSH
Prognosis MeSH
Prospective Studies MeSH
Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
Neoplasm, Residual drug therapy mortality pathology MeSH
Risk Factors MeSH
Neoplasm Staging MeSH
Hematopoietic Stem Cell Transplantation MeSH
Check Tag
Child MeSH
Humans MeSH
Adolescent MeSH
Male MeSH
Female MeSH
Publication type
Journal Article MeSH
Multicenter Study MeSH
Research Support, Non-U.S. Gov't MeSH

The prognosis for children with high-risk relapsed acute lymphoblastic leukemia (ALL) is poor. Here, we assessed the prognostic importance of response during induction and consolidation treatment prior to hematopoietic stem cell transplantation (HSCT) aiming to evaluate the best time to assess minimal residual disease (MRD) for intervention strategies and in future trials in high-risk ALL relapse patients. Included patients (n=125) were treated uniformly according to the ALL-REZ BFM (Berlin-Frankfurt-Münster) 2002 relapse trial (median follow-up time=4.8 years). Patients with MRD ⩾10(-3) after induction treatment (76/119, 64%) or immediately preceding HSCT (19/71, 27%) had a significantly worse probability of disease-free survival 10 years after relapse treatment begin, with 26% (±6%) or 23% (±7%), respectively, compared with 58% (±8%) or 48% (±7%) for patients with MRD <10(-3). Conventional intensive consolidation treatment reduced MRD to <10(-3) before HSCT in 63% of patients, whereas MRD remained high or increased in the rest of this patient group. Our data support that MRD after induction treatment can be used to quantify the activity of different induction treatment strategies in phase II trials. MRD persistence at ⩾10(-3) before HSCT reflects a disease highly resistant to conventional intensive chemotherapy and requiring prospective controlled investigation of new treatment strategies and drugs.

] Department of Pediatric Hematology and Oncology Charles University 2nd Medical School and University Hospital Motol Prague Czech Republic [2] CLIP Childhood Leukemia Investigation Prague Prague Czech Republic

Department of Pediatric Hematology and Oncology University Medical Center Hamburg Eppendorf Hamburg Germany

Department of Pediatric Oncology Hematology and Clinical Immunology Heinrich Heine University Duesseldorf Germany

Department of Pediatric Oncology Hematology Charité Universitätsmedizin Berlin Berlin Germany

Department of Pediatric Oncology University Children's Hospital Zurich Switzerland

Department of Pediatrics University of Schleswig Holstein Kiel Germany

Hospital for Children and Adolescents Goethe University Hospital Frankfurt Frankfurt Germany

St Anna Children's Research Institute and Children's Hospital Medical University of Vienna Vienna Austria

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