Persistent MRD before and after allogeneic BMT predicts relapse in children with acute lymphoblastic leukaemia

Summary Minimal residual disease (MRD) during early chemotherapy is a powerful predictor of relapse in acute lymphoblastic leukaemia (ALL) and is used in children to determine eligibility for allogeneic haematopoietic stem cell transplantation (HSCT) in first (CR1) or later complete remission (CR2/C...

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Published in:British journal of haematology 2015-02, Vol.168 (3), p.395-404
Main Authors: Sutton, Rosemary, Shaw, Peter J., Venn, Nicola C., Law, Tamara, Dissanayake, Anuruddhika, Kilo, Tatjana, Haber, Michelle, Norris, Murray D., Fraser, Chris, Alvaro, Frank, Revesz, Tamas, Trahair, Toby N., Dalla‐Pozza, Luciano, Marshall, Glenn M., O'Brien, Tracey A.
Format: Article
Language:English
Subjects:
acute lymphoblastic leukaemia
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
bone marrow transplantation
Child
childhood leukaemia
Combined Modality Therapy
Female
Gene Deletion
Hematopoietic Stem Cell Transplantation - methods
Humans
Ikaros Transcription Factor - genetics
IKZF1
Kaplan-Meier Estimate
Male
minimal residual disease
Neoplasm Proteins - genetics
Neoplasm, Residual
Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Prognosis
Recurrence
Transplantation Conditioning - methods
Treatment Outcome
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Summary:Summary Minimal residual disease (MRD) during early chemotherapy is a powerful predictor of relapse in acute lymphoblastic leukaemia (ALL) and is used in children to determine eligibility for allogeneic haematopoietic stem cell transplantation (HSCT) in first (CR1) or later complete remission (CR2/CR3). Variables affecting HSCT outcome were analysed in 81 children from the ANZCHOG ALL8 trial. The major cause of treatment failure was relapse, with a cumulative incidence of relapse at 5 years (CIR) of 32% and treatment‐related mortality of 8%. Leukaemia‐free survival (LFS) and overall survival (OS) were similar for HSCT in CR1 (LFS 62%, OS 83%, n = 41) or CR2/CR3 (LFS 60%, OS 72%, n = 40). Patients achieving bone marrow MRD negativity pre‐HSCT had better outcomes (LFS 83%, OS 92%) than those with persistent MRD pre‐HSCT (LFS 41%, OS 64%, P 
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.13142