Clinical significant of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse

E. Coustan-Smith, A. Gajjar, N. Hijiya, B. I. Razzouk, R. C. Ribeiro, G. K. Rivera, J. E. Rubnitz, J. T. Sandlund, M. Andreansky, M. L. Hancock, C. H. Pui, Dario Campana

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99 Scopus citations

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 languageEnglish (US)
Pages (from-to)499-504
Number of pages6
JournalLeukemia
Volume18
Issue number3
DOIs
StatePublished - Mar 2004
Externally publishedYes

Keywords

  • Acute lymphoblastic leukemia
  • Flow cytometry
  • Minimal residual disease
  • Relapse

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

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  • Cite this

    Coustan-Smith, E., Gajjar, A., Hijiya, N., Razzouk, B. I., Ribeiro, R. C., Rivera, G. K., Rubnitz, J. E., Sandlund, J. T., Andreansky, M., Hancock, M. L., Pui, C. H., & Campana, D. (2004). Clinical significant of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. Leukemia, 18(3), 499-504. https://doi.org/10.1038/sj.leu.2403283