Prognostic value of low-level MRD in adult acute lymphoblastic leukemia detected by low- and high-throughput methods

• Verfasst von: Kotrová, Michaela [VerfasserIn]
• Verfasst von: Koopmann, Johannes [VerfasserIn]
• Verfasst von: Trautmann, Heiko [VerfasserIn]
• Verfasst von: Alakel, Nael [VerfasserIn]
• Verfasst von: Beck, Joachim [VerfasserIn]
• Verfasst von: Nachtkamp, Kathrin [VerfasserIn]
• Verfasst von: Steffen, Björn [VerfasserIn]
• Verfasst von: Raffel, Simon [VerfasserIn]
• Verfasst von: Viardot, Andreas [VerfasserIn]
• Verfasst von: Wethmar, Klaus [VerfasserIn]
• Verfasst von: Darzentas, Nikos [VerfasserIn]
• Verfasst von: Baldus, Claudia D. [VerfasserIn]
• Verfasst von: Gökbuget, Nicola [VerfasserIn]
• Verfasst von: Brüggemann, Monika [VerfasserIn]
• Titel: Prognostic value of low-level MRD in adult acute lymphoblastic leukemia detected by low- and high-throughput methods
• Verf.angabe: Michaela Kotrová, Johannes Koopmann, Heiko Trautmann, Nael Alakel, Joachim Beck, Kathrin Nachtkamp, Björn Steffen, Simon Raffel, Andreas Viardot, Klaus Wethmar, Nikos Darzentas, Claudia D. Baldus, Nicola Gökbuget, and Monika Brüggemann
• E-Jahr: 2022
• Jahr: May 16, 2022
• Umfang: 5 S.
• Fussnoten: Gesehen am 25.08.2022
• Titel Quelle: Enthalten in: Blood advances
• Ort Quelle: Washington, DC : American Society of Hematology, 2016
• Jahr Quelle: 2022
• Band/Heft Quelle: 6(2022), 10, Seite 3006-3010
• ISSN Quelle: 2473-9537
• DOI: doi:10.1182/bloodadvances.2021006727
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1815198273

Abstract

Persistence of minimal residual disease (MRD) after induction/consolidation therapy in acute lymphoblastic leukemia is the leading cause of relapse. The GMALL 07/2003 study used MRD detection by real-time quantitative polymerase chain reaction of clonal immune gene rearrangements with 1 × 10−4 as discriminating cutoff: levels ≥1 × 10−4 define molecular failure and MRD-negativity with an assay sensitivity of at least 1 × 10−4 defining complete molecular response. The clinical relevance of MRD results not fitting into these categories is unclear and termed “molecular not evaluable” (MolNE) toward MRD-based treatment decisions. Within the GMALL 07/03 study, 1019 consecutive bone marrow samples after first consolidation were evaluated for MRD. Patients with complete molecular response had significantly better outcome (5-year overall survival [OS] = 85% ± 2%, n = 603; 5-year disease-free survival [DFS] = 73% ± 2%, n = 599) compared with patients with molecular failure (5-year OS = 40% ± 3%, n = 238; 5-year DFS = 29% ± 3%, n = 208), with patients with MolNE in between (5-year OS = 66% ± 4%; 5-year DFS = 52% ± 4%, n = 178). Of MolNE samples reanalyzed using next-generation sequencing (NGS), patients with undetectable NGS-MRD (n = 44; 5-year OS = 88% ± 5%, 5-year DFS = 70% ± 7%) had significantly better outcome than those with positive NGS-MRD (n = 42; 5-year OS = 37% ± 8%; 5-year DFS = 33% ± 8%). MolNE MRD results not just are borderline values with questionable relevance but also form an intermediate-risk group, assignment of which can be further improved by NGS.