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. 2014 Aug;14(4):319-26.
doi: 10.1016/j.clml.2014.01.002. Epub 2014 Jan 15.

The effect of peritransplant minimal residual disease in adults with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation

Yi Zhou  1 , Rebecca Slack  2 , Jeffrey L Jorgensen  1 , Sa A Wang  1 , Gabriela Rondon  3 , Marcos de Lima  3 , Elizabeth Shpall  3 , Uday Popat  3 , Stefan Ciurea  3 , Amin Alousi  3 , Muzaffar Qazilbash  3 , Chitra Hosing  3 , Susan O'Brien  4 , Deborah Thomas  4 , Hagop Kantarjian  4 , L Jeffrey Medeiros  1 , Richard E Champlin  3 , Partow Kebriaei  5
Affiliations

The effect of peritransplant minimal residual disease in adults with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation

Yi Zhou et al. Clin Lymphoma Myeloma Leuk. 2014 Aug.

Abstract

Background: Allogeneic HSCT is highly effective for treating ALL. However, many ALL patients relapse after HSCT. There has been a continuing effort to improve identification of patients at high risk of relapse, with the goal of early intervention to improve outcome.

Patients and methods: In this retrospective analysis, we examined the effect of MRD on the risk of hematologic relapse in 149 adult patients with ALL in morphologic remission undergoing allogeneic HSCT. MRD was assessed at the time of HSCT and after HSCT.

Results: Patients with pretransplant MRD had a trend for shorter progression-free survival (PFS) at 2 years compared with patients without MRD, nearing statistical significance; 28% versus 47%, P = .08, on univariate analysis. This trend remained on multivariate analysis with better PFS in patients without MRD at the time of HSCT, hazard ratio (HR), 0.62 (95% confidence interval, 0.37-1.04); P = .07. Additionally, emergence of MRD after HSCT was a strong predictor for overt hematologic relapse (HR, 4; P < .001) with a median latency interval of 3.8 months.

Conclusion: These findings demonstrate the predictive value of monitoring for MRD around the time of transplant in adult patients with ALL.

Keywords: Flow cytometry; Monitoring; Predictor; Prognosis; Relapse.

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Figures

Figure 1A
Figure 1A
Overall Survival by Pre-Transplant Minimal Residual Disease Status
Figure 1B
Figure 1B
Progression-Free Survival by Pre-Transplant Minimal Residual Disease Status
Figure 2A
Figure 2A
Time to MRD after Transplant.
Figure 2B
Figure 2B
Time to Progression after Post-Transplant MRD among Patients with MRD
See this image and copyright information in PMC

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