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Review
. 2014 Sep 1;6(1):e2014062.
doi: 10.4084/MJHID.2014.062. eCollection 2014.

Prognostic significance and treatment implications of minimal residual disease studies in Philadelphia-negative adult acute lymphoblastic leukemia

Orietta Spinelli  1 , Manuela Tosi  1 , Barbara Peruta  1 , Marie Lorena Guinea Montalvo  1 , Elena Maino  2 , Anna Maria Scattolin  2 , Margherita Parolini  1 , Piera Viero  2 , Alessandro Rambaldi  1 , Renato Bassan  2
Affiliations
Review

Prognostic significance and treatment implications of minimal residual disease studies in Philadelphia-negative adult acute lymphoblastic leukemia

Orietta Spinelli et al. Mediterr J Hematol Infect Dis. .

Abstract

Acute lymphoblastic leukemia (ALL) is curable in about 40-50% of adult patients, however this is subject to ample variations owing to several host- and disease-related prognostic characteristics. Currently, the study of minimal residual disease (MRD) following induction and early consolidation therapy stands out as the most sensitive individual prognostic marker to define the risk of relapse following the achievement of remission, and ultimately that of treatment failure or success. Because substantial therapeutic advancement is now being achieved using intensified pediatric-type regimens, MRD analysis is especially useful to orientate stem cell transplantation choices. These strategic innovations are progressively leading to greater than 50% cure rates.

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Figures

Figure 1
Figure 1
The relationship between MRD-based risk definition and treatment in adult ALL. A) CR patients achieving good/complete and durable MRD response are at low risk of recurrence and can achieve cure on standard chemotherapy only. B) CR patients with insufficient MRD clearing or MRD relapse subsequent to MRD remission, are at high risk of relapse and cannot be cured by chemotherapy. A significant proportion of these cases can be effectively rescued by an allo-SCT.
See this image and copyright information in PMC

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