Very early/early relapses of acute lymphoblastic leukemia show unexpected changes of clonal markers and high heterogeneity in response to initial and relapse treatment

• Verfasst von: Eckert, Cornelia [VerfasserIn]
• Verfasst von: Flohr, T. [VerfasserIn]
• Verfasst von: Köhler, Rolf [VerfasserIn]
• Verfasst von: Hagedorn, N. [VerfasserIn]
• Verfasst von: Moericke, A. [VerfasserIn]
• Verfasst von: Stanulla, M. [VerfasserIn]
• Verfasst von: Kirschner-Schwabe, R. [VerfasserIn]
• Verfasst von: Cario, G. [VerfasserIn]
• Verfasst von: Stackelberg, Av [VerfasserIn]
• Verfasst von: Bartram, Claus R. [VerfasserIn]
• Verfasst von: Henze, G. [VerfasserIn]
• Verfasst von: Schrappe, M. [VerfasserIn]
• Verfasst von: Schrauder, A. [VerfasserIn]
• Titel: Very early/early relapses of acute lymphoblastic leukemia show unexpected changes of clonal markers and high heterogeneity in response to initial and relapse treatment
• Verf.angabe: C. Eckert, T. Flohr, R. Koehler, N. Hagedorn, A. Moericke, M. Stanulla, R. Kirschner-Schwabe, G. Cario, Av Stackelberg, C.R. Bartram, G. Henze, M. Schrappe and A. Schrauder
• E-Jahr: 2011
• Jahr: 06 May 2011
• Umfang: 9 S.
• Fussnoten: Gesehen am 04.04.2022
• Titel Quelle: Enthalten in: Leukemia
• Ort Quelle: London : Springer Nature, 1997
• Jahr Quelle: 2011
• Band/Heft Quelle: 25(2011), 8, Seite 1305-1313
• ISSN Quelle: 1476-5551
• DOI: doi:10.1038/leu.2011.89
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Acute lymphocytic leukaemia
• Sach-SW: Cancer therapy
• K10plus-PPN: 1797453343

Abstract

Minimal residual disease (MRD) quantified after induction treatment of childhood acute lymphoblastic leukemia (ALL) predicts risk of relapse. It has been assumed that early relapses derive from a residual population of leukemic cells, which is still present after induction and that relapsed disease will consequently be more resistant to treatment. To test these hypotheses, we performed a prospective study on patients treated according to the frontline-trial ALL-BFM 2000, which used MRD response for risk-group stratification. Patients (n=45) showed a median time to relapse of 1.5 years. In 89% of patients at least one T-cell-receptor/immunoglobulin gene rearrangement chosen for initial MRD quantification remained stable; however, at least one of the preferred markers for MRD stratification at relapse was different to diagnosis in 50% of patients. A similar proportion of very early, early and late relapses appeared to gain a marker at relapse although backtracking-analysis revealed that in 77% of cases, the gained markers were present as small sub-clones at initial diagnosis. Comparing initial and relapse MRD response to induction, 38% of patients showed a similar, 38% a better and 25% a poorer response after relapse. These data demonstrate an unexpectedly high clonal heterogeneity among very early/early relapses and challenge some current assumptions about relapsed ALL.