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Value of flow cytometry for MRD-based relapse prediction in B-cell precursor ALL in a multicenter setting.
- Source :
-
Leukemia [Leukemia] 2021 Jul; Vol. 35 (7), pp. 1894-1906. Date of Electronic Publication: 2020 Dec 14. - Publication Year :
- 2021
-
Abstract
- PCR of TCR/Ig gene rearrangements is considered the method of choice for minimal residual disease (MRD) quantification in BCP-ALL, but flow cytometry analysis of leukemia-associated immunophenotypes (FCM-MRD) is faster and biologically more informative. FCM-MRD performed in 18 laboratories across seven countries was used for risk stratification of 1487 patients with BCP-ALL enrolled in the NOPHO ALL2008 protocol. When no informative FCM-marker was available, risk stratification was based on real-time quantitative PCR. An informative FCM-marker was found in 96.2% and only two patients (0.14%) had non-informative FCM and non-informative PCR-markers. The overall 5-year event-free survival was 86.1% with a cumulative incidence of relapse (CIR <subscript>5y</subscript> ) of 9.5%. FCM-MRD levels on days 15 (HzR 4.0, p < 0.0001), 29 (HzR 2.7, p < 0.0001), and 79 (HzR 3.5, p < 0.0001) associated with hazard of relapse adjusted for age, cytogenetics, and WBC. The early (day 15) response associated with CIR <subscript>5y</subscript> adjusted for day 29 FCM-MRD, with higher levels in adults (median 2.4 × 10 <superscript>-2</superscript> versus 5.2 × 10 <superscript>-3</superscript> , p < 0.0001). Undetectable FCM- and/or PCR-MRD on day 29 identified patients with a very good outcome (CIR <subscript>5y</subscript> = 3.2%). For patients who did not undergo transplantation, day 79 FCM-MRD > 10 <superscript>-4</superscript> associated with a CIR <subscript>5y</subscript> = 22.1%. In conclusion, FCM-MRD performed in a multicenter setting is a clinically useful method for MRD-based treatment stratification in BCP-ALL.
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Female
Flow Cytometry methods
Humans
Immunophenotyping methods
Infant
Male
Middle Aged
Recurrence
Young Adult
Neoplasm, Residual drug therapy
Neoplasm, Residual pathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology
Precursor Cells, B-Lymphoid drug effects
Precursor Cells, B-Lymphoid pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5551
- Volume :
- 35
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Leukemia
- Publication Type :
- Academic Journal
- Accession number :
- 33318611
- Full Text :
- https://doi.org/10.1038/s41375-020-01100-5