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Clinical value of pre-transplant minimal residual disease in childhood lymphoblastic leukaemia: the results of the French minimal residual disease-guided protocol.
- Source :
- British Journal of Haematology; May2014, Vol. 165 Issue 3, p392-401, 10p
- Publication Year :
- 2014
-
Abstract
- Minimal residual disease ( MRD) is a major predictive factor of the cure rate of acute lymphoblastic leukaemia ( ALL). Haematopoietic cell transplantation is a treatment option for patients at high risk of relapse. Between 2005 and 2008, we conducted a prospective study evaluating the feasibility and efficacy of the reduction of immunosuppressive medication shortly after a non- ex vivo T depleted myeloablative transplantation. Immunoglobulin (Ig)H/T-cell receptor MRD 30 d before transplant could be obtained in 122 of the 133 cases of high-risk paediatric ALL enrolled. There were no significant demographic differences except remission status (first or second complete remission) between the 95 children with MRD <10<superscript>−3</superscript> and the 27 with MRD ≥10<superscript>−3</superscript>. Multivariate analysis identified sex match and MRD as being significantly associated with 5-year survival. MRD ≥10<superscript>−3</superscript> compromised the 5-year cumulative incidence of relapse (43·6 vs. 16·7%). Complete remission status and stem cell source did not modify the relationship between MRD and prognosis. Thus, pre-transplant MRD is still a major predictor of outcome for ALL. The MRD-guided strategy resulted in survival for 72·3% of patients with MRD<10<superscript>−3</superscript> and 40·4% of those with MRD ≥10<superscript>−3</superscript>. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00071048
- Volume :
- 165
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- British Journal of Haematology
- Publication Type :
- Academic Journal
- Accession number :
- 95514940
- Full Text :
- https://doi.org/10.1111/bjh.12749