The prognostic value of MRD in large series of childhood T-ALL has not yet been established. Trial AIEOP-BFM-ALL 2000 introduced standardized quantitative assessment of MRD for stratification, based on immunoglobulin and TCR gene rearrangements as polymerase chain reaction targets: Patients were considered MRD standard risk (MRD-SR) if MRD was negative at day 33 (time point 1 [TP1]) and day 78 (TP2), analyzed by at least 2 sensitive markers; MRD intermediate risk (MRD-IR) if positive either at day 33 or 78 and < 10(-3) at day 78; and MRD high risk (MRD-HR) if >= 10(-3) at day 78. A total of 464 patients with T-ALL were stratified by MRD: 16% of them were MRD-SR, 63% MRD-IR, and 21% MRD-HR. Their 7-year event-free-survival (SE) was 91.1% (3.5%), 80.6% (2.3%), and 49.8% (5.1%) (P < .001), respectively. Negativity of MRD at TP1 was the most favorable prognostic factor. An excellent outcome was also obtained in 32% of patients turning MRD negative only at TP2, indicating that early (TP1) MRD levels were irrelevant if MRD at TP2 was negative (48% of all patients). MRD >= 10(-3) at TP2 constitutes the most important predictive factor for relapse in childhood T-ALL. The study is registered at http://www.clinicaltrials.gov; "Combination Chemotherapy Based on Risk of Relapse in Treating Young Patients With Acute Lymphoblastic Leukemia," protocol identification #NCT00430118 for BFM and #NCT00613457 for AIEOP. (Blood. 2011;118(8):2077-2084)

Schrappe, M., Valsecchi, M. G., Bartram, C. R., Schrauder, A., Panzer-Grümayer, R., Möricke, A., Parasole, R., Zimmermann, M., Dworzak, M., Buldini, B., Reiter, A., Basso, G., Klingebiel, T., Messina, C., Ratei, R., Cazzaniga, G., Koehler, R., Locatelli, F., Schäfer, B. W., Aricò, M., Welte, K., Van Dongen, J. J. M., Gadner, H., Biondi, A., Conter, V., Late MRD response determines relapse risk overall and in subsets of childhood T-cell ALL: results of the AIEOP-BFM-ALL 2000 study, <<BLOOD>>, 2011; 118 (8): 2077-2084. [doi:10.1182/blood-2011-03-338707] [https://hdl.handle.net/10807/247474]

Late MRD response determines relapse risk overall and in subsets of childhood T-cell ALL: results of the AIEOP-BFM-ALL 2000 study

Locatelli, Franco;
2011

Abstract

The prognostic value of MRD in large series of childhood T-ALL has not yet been established. Trial AIEOP-BFM-ALL 2000 introduced standardized quantitative assessment of MRD for stratification, based on immunoglobulin and TCR gene rearrangements as polymerase chain reaction targets: Patients were considered MRD standard risk (MRD-SR) if MRD was negative at day 33 (time point 1 [TP1]) and day 78 (TP2), analyzed by at least 2 sensitive markers; MRD intermediate risk (MRD-IR) if positive either at day 33 or 78 and < 10(-3) at day 78; and MRD high risk (MRD-HR) if >= 10(-3) at day 78. A total of 464 patients with T-ALL were stratified by MRD: 16% of them were MRD-SR, 63% MRD-IR, and 21% MRD-HR. Their 7-year event-free-survival (SE) was 91.1% (3.5%), 80.6% (2.3%), and 49.8% (5.1%) (P < .001), respectively. Negativity of MRD at TP1 was the most favorable prognostic factor. An excellent outcome was also obtained in 32% of patients turning MRD negative only at TP2, indicating that early (TP1) MRD levels were irrelevant if MRD at TP2 was negative (48% of all patients). MRD >= 10(-3) at TP2 constitutes the most important predictive factor for relapse in childhood T-ALL. The study is registered at http://www.clinicaltrials.gov; "Combination Chemotherapy Based on Risk of Relapse in Treating Young Patients With Acute Lymphoblastic Leukemia," protocol identification #NCT00430118 for BFM and #NCT00613457 for AIEOP. (Blood. 2011;118(8):2077-2084)
2011
Inglese
Schrappe, M., Valsecchi, M. G., Bartram, C. R., Schrauder, A., Panzer-Grümayer, R., Möricke, A., Parasole, R., Zimmermann, M., Dworzak, M., Buldini, B., Reiter, A., Basso, G., Klingebiel, T., Messina, C., Ratei, R., Cazzaniga, G., Koehler, R., Locatelli, F., Schäfer, B. W., Aricò, M., Welte, K., Van Dongen, J. J. M., Gadner, H., Biondi, A., Conter, V., Late MRD response determines relapse risk overall and in subsets of childhood T-cell ALL: results of the AIEOP-BFM-ALL 2000 study, <<BLOOD>>, 2011; 118 (8): 2077-2084. [doi:10.1182/blood-2011-03-338707] [https://hdl.handle.net/10807/247474]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/247474
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