Abstract
Using flow cytometric techniques capable of detecting 0.01% leukemic cells, we prospectively studied minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL) after first relapse. At the end of remission reinduction, 41 patients had a bone marrow sample adequate for MRD studies; 35 of these were in morphologic remission. Of the 35 patients, 19 (54%) had MRD ≥0.01%, a finding that was associated with subsequent leukemia relapse. The 2-year cumulative incidence of second leukemia relapse was 70.2±12.3% for the 19 MRD-positive patients and 27.9±12.4% for the 16 MRD-negative patients (P=0.008). Among patients with a first relapse off therapy, 2-year second relapse rates were 49.1±17.8% in the 12 MRD-positive and 0% in the 11 MRD-negative patients (P=0.014); among those who received only chemotherapy after first relapse, the 2-year second relapse rates were 81.5±14.40% (n=12) and 25.0± 13.1% (n=13), respectively (P=0.004). Time of first relapse and MRD were the only two significant predictors of outcome In a multivariate analysis. We conclude that MRD assays should be used to guide the selection of postremission therapy in patients with ALL in first relapse.
Original language | English (US) |
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Pages (from-to) | 499-504 |
Number of pages | 6 |
Journal | Leukemia |
Volume | 18 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2004 |
Keywords
- Acute lymphoblastic leukemia
- Flow cytometry
- Minimal residual disease
- Relapse
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research