Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblastic leukemia: results in 3184 patients of the AIEOP-BFM ALL 2000 study

作者:Conter Valentino; Bartram Claus R; Valsecchi Maria Grazia; Schrauder Andre; Panzer Gruemayer Renate; Moericke Anja; Arico Maurizio; Zimmermann Martin; Mann Georg; De Rossi Giulio; Stanulla Martin; Locatelli Franco; Basso Giuseppe; Niggli Felix; Barisone Elena; Henze Guenter; Ludwig Wolf Dieter; Haas Oskar A; Cazzaniga Giovanni; Koehler Rolf; Silvestri Daniela; Bradtke Jutta; Parasole Rosanna; Beier Rita; van Dongen Jacques J M; Biondi Andrea*; Schrappe Martin
来源:Blood, 2010, 115(16): 3206-3214.
DOI:10.1182/blood-2009-10-248146

摘要

The Associazione Italiana di Ematologia Oncologia Pediatrica and the Berlin-Frankfurt-Munster Acute Lymphoblastic Leukemia (AIEOP-BFM ALL 2000) study has for the first time introduced standardized quantitative assessment of minimal residual disease (MRD) based on immunoglobulin and T-cell receptor gene rearrangements as polymerase chain reaction targets (PCR-MRD), at 2 time points (TPs), to stratify patients in a large prospective study. Patients with precursor B (pB) ALL (n = 3184) were considered MRD standard risk (MRD-SR) if MRD was already negative at day 33 (analyzed by 2 markers, with a sensitivity of at least 10(-4)); MRD high risk (MRD-HR) if 10(-3) or more at day 78 and MRD intermediate risk (MRD-IR): others. MRD-SR patients were 42% (1348): 5-year event-free survival (EFS, standard error) is 92.3% (0.9). Fifty-two percent (1647) were MRD-IR: EFS 77.6% (1.3). Six percent of patients (189) were MRD-HR: EFS 50.1% (4.1; P < .001). PCR-MRD discriminated prognosis even on top of white blood cell count, age, early response to prednisone, and genotype. MRD response detected by sensitive quantitative PCR at 2 predefined TPs is highly predictive for relapse in childhood pB-ALL. The study is registered at http://clinicaltrials.gov: NCT00430118 for BFM and NCT00613457 for AIEOP. (Blood. 2010; 115(16): 3206-3214)

  • 出版日期2010-4-22