Detection of MRD may predict the outcome of patients with Philadelphia chromosome-positive ALL treated with tyrosine kinase inhibitors plus chemotherapy

作者：Ravandi Farhad^*; Jorgensen Jeffrey L; Thomas Deborah A; O' Brien Susan; Garris Rebecca; Faderl Stefan; Huang Xuelin; Wen Sijin; Burger Jan A; Ferrajoli Alessandra; Kebriaei Partow; Champlin Richard E; Estrov Zeev; Challagundla Pramoda; Wang Sa A; Luthra Rajyalakshmi; Cortes Jorge E; Kantarjian Hagop M

来源：Blood, 2013, 122(7): 1214-1221.

DOI：10.1182/blood-2012-11-466482

From 2001 to 2011, 122 patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia were treated with chemotherapy + imatinib (n = 54) or + dasatinib (n 5 68). One hundred fifteen (94%) achieved complete remission (CR) including 101 patients who achieved it with only 1 induction course and had at least + minimal residual disease (MRD) assessment; 25 patients underwent an allogeneic stemcell transplant in first CR and were excluded, leaving 76 patients as the subject of this report. MRDmonitoring by multiparameter flow cytometry (MFC) and real-time quantitative polymerase chain reaction (PCR) was performed at the end of induction and at similar to 3-month intervals thereafter. Median age was 54 years (range, 21-84 years). There was no difference in survival by achievement of at least amajor molecular response (MMR; BCR-ABL/ABL %26lt; 0.1%) at CR (P =.22). Patients achieving MMR at 3, 6, 9, and 12 months had a better survival (P =.02,.04,.05, and.01, respectively). Negative MFC at CR did not predict for improved survival (P =.2). At 3 and 12 months, negative MRD by MFC was associated with improved survival (P =.04 and .001). MRD monitoring by PCR and MFC identifies patients who benefit from treatment intensification in first CR.

• 出版日期2013-8-15