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Detection of minimal residual disease following induction immunochemotherapy predicts progression free survival in mantle cell lymphoma: final results of CALGB 59909.
- Source :
-
Haematologica [Haematologica] 2012 Apr; Vol. 97 (4), pp. 579-85. Date of Electronic Publication: 2011 Nov 18. - Publication Year :
- 2012
-
Abstract
- Background: In the present study, the prognostic impact of minimal residual disease during treatment on time to progression and overall survival was analyzed prospectively in patients with mantle cell lymphoma treated on the Cancer and Leukemia Group B 59909 clinical trial.<br />Design and Methods: Peripheral blood and bone marrow samples were collected during different phases of the Cancer and Leukemia Group B 59909 study for minimal residual disease analysis. Minimal residual disease status was determined by quantitative polymerase chain reaction of IgH and/or BCL-1/JH gene rearrangement. Correlation of minimal residual disease status with time to progression and overall survival was determined. In multivariable analysis, minimal residual disease, and other risk factors were correlated with time to progression.<br />Results: Thirty-nine patients had evaluable, sequential peripheral blood and bone marrow samples for minimal residual disease analysis. Using peripheral blood monitoring, 18 of 39 (46%) achieved molecular remission following induction therapy. The molecular remission rate increased from 46 to 74% after one course of intensification therapy. Twelve of 21 minimal residual disease positive patients (57%) progressed within three years of follow up compared to 4 of 18 (22%) molecular remission patients (P=0.049). Detection of minimal residual disease following induction therapy predicted disease progression with a hazard ratio of 3.7 (P=0.016). The 3-year probability of time to progression among those who were in molecular remission after induction chemotherapy was 82% compared to 48% in patients with detectable minimal residual disease. The prediction of time to progression by post-induction minimal residual disease was independent of other prognostic factors in multivariable analysis.<br />Conclusions: Detection of minimal residual disease following induction immunochemotherapy was an independent predictor of time to progression following immunochemotherapy and autologous stem cell transplantation for mantle cell lymphoma.
- Subjects :
- Adult
Aged
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, Mantle-Cell mortality
Middle Aged
Neoplasm, Residual
Prognosis
Survival Analysis
Transplantation, Autologous
Treatment Outcome
Immunotherapy
Induction Chemotherapy
Lymphoma, Mantle-Cell diagnosis
Lymphoma, Mantle-Cell therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1592-8721
- Volume :
- 97
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Haematologica
- Publication Type :
- Academic Journal
- Accession number :
- 22102709
- Full Text :
- https://doi.org/10.3324/haematol.2011.050203