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, Martin Andreansky, M. L. Hancock, C. H. Pui, Dario Campana

Research output: Contribution to journalArticle

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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
Pages (from-to)499-504
Number of pages6
JournalLeukemia
Volume18
Issue number3
DOIs
StatePublished - Mar 1 2004
Externally publishedYes

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Residual Neoplasm
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Recurrence
Leukemia
Multivariate Analysis
Bone Marrow
Drug Therapy
Incidence
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

Cite this

Coustan-Smith, E., Gajjar, A., Hijiya, N., Razzouk, B. I., Ribeiro, R. C., Rivera, G. K., ... 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

Clinical significant of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. / Coustan-Smith, E.; Gajjar, A.; Hijiya, N.; Razzouk, B. I.; Ribeiro, R. C.; Rivera, G. K.; Rubnitz, J. E.; Sandlund, J. T.; Andreansky, Martin; Hancock, M. L.; Pui, C. H.; Campana, Dario.

In: Leukemia, Vol. 18, No. 3, 01.03.2004, p. 499-504.

Research output: Contribution to journalArticle

Coustan-Smith, E, Gajjar, A, Hijiya, N, Razzouk, BI, Ribeiro, RC, Rivera, GK, Rubnitz, JE, Sandlund, JT, Andreansky, M, Hancock, ML, Pui, CH & Campana, D 2004, 'Clinical significant of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse', Leukemia, vol. 18, no. 3, pp. 499-504. https://doi.org/10.1038/sj.leu.2403283
Coustan-Smith E, Gajjar A, Hijiya N, Razzouk BI, Ribeiro RC, Rivera GK et al. Clinical significant of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. Leukemia. 2004 Mar 1;18(3):499-504. https://doi.org/10.1038/sj.leu.2403283
Coustan-Smith, E. ; Gajjar, A. ; Hijiya, N. ; Razzouk, B. I. ; Ribeiro, R. C. ; Rivera, G. K. ; Rubnitz, J. E. ; Sandlund, J. T. ; Andreansky, Martin ; Hancock, M. L. ; Pui, C. H. ; Campana, Dario. / Clinical significant of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. In: Leukemia. 2004 ; Vol. 18, No. 3. pp. 499-504.
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