TY - JOUR
T1 - The effect of peritransplant minimal residual disease in adults with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation
AU - Zhou, Yi
AU - Slack, Rebecca
AU - Jorgensen, Jeffrey L.
AU - Wang, Sa A.
AU - Rondon, Gabriela
AU - De Lima, Marcos
AU - Shpall, Elizabeth
AU - Popat, Uday
AU - Ciurea, Stefan
AU - Alousi, Amin
AU - Qazilbash, Muzaffar
AU - Hosing, Chitra
AU - O'Brien, Susan
AU - Thomas, Deborah
AU - Kantarjian, Hagop
AU - Medeiros, L. Jeffrey
AU - Champlin, Richard E.
AU - Kebriaei, Partow
PY - 2014/8
Y1 - 2014/8
N2 - 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. Published by Elsevier Inc.
AB - 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. Published by Elsevier Inc.
KW - Flow cytometry
KW - Monitoring
KW - Predictor
KW - Prognosis
KW - Relapse
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U2 - 10.1016/j.clml.2014.01.002
DO - 10.1016/j.clml.2014.01.002
M3 - Article
C2 - 24548609
AN - SCOPUS:84904709033
SN - 2152-2650
VL - 14
SP - 319
EP - 326
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 4
ER -