Prognostic role of minimal residual disease in mature B-cell acute lymphoblastic leukemia of childhood

Lara Mussolin, Marta Pillon, Valentino Conter, Matilde Piglione, Luca Lo Nigro, Paolo Pierani, Concetta Micalizzi, Salvatore Buffardi, Giuseppe Basso, Luigi Zanesco, Angelo Rosolen

Research output: Contribution to journalArticle

Abstract

Purpose: To study the prevalence of t(8;14) at diagnosis and the response kinetics to treatment of minimal residual disease (MRD) in B-cell acute lymphoblastic leukemia (B-ALL) patients and determine its impact on prognosis. Patients and Methods: A total of 68 children affected by de novo B-ALL enrolled onto the Berlin-Frankfurt-Muenster-based Italian Association of Pediatric Hematology and Oncology LNH-97 clinical protocol were studied. Bone marrow aspirate from each patient was analyzed for the presence of t(8;14)(q24; q32) by long-distance polymerase chain reaction at diagnosis, after the first chemotherapy cycle, and after subsequent cycles until negative for MRD. Morphologic and immunophenotypic analyses were reviewed centrally. Results: A total of 47 patients (69%) were positive for t(8;14)(q24;q32). MRD response kinetics was determined in 39 patients. All of them reached clinical complete remission and most (31 of 39) became MRD negative after the first chemotherapy cycle. The 3-year relapse-free survival (RFS) was 38% (SE = 17%) in patients MRD positive after the first chemotherapy cycle compared with 84% (SE = 7%) in MRD-negative patients (P = .0005), whereas there was no difference in RFS for children who reached a clinical complete remission after the first chemotherapy cycle versus those who did not (RFS = 72% and SE = 9%; RFS = 79% and SE = 11%, respectively; P = .8). In multivariate analysis, MRD was shown to be predictive of higher risk of failure. Conclusion: Our study demonstrated that MRD carries a negative prognostic impact in B-ALL patients and suggests that a better risk-adapted therapy, possibly including the use of anti-CD20 monoclonal antibody, should be considered in selected patients.

Original languageEnglish
Pages (from-to)5254-5261
Number of pages8
JournalJournal of Clinical Oncology
Volume25
Issue number33
DOIs
Publication statusPublished - Nov 20 2007

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Mussolin, L., Pillon, M., Conter, V., Piglione, M., Lo Nigro, L., Pierani, P., Micalizzi, C., Buffardi, S., Basso, G., Zanesco, L., & Rosolen, A. (2007). Prognostic role of minimal residual disease in mature B-cell acute lymphoblastic leukemia of childhood. Journal of Clinical Oncology, 25(33), 5254-5261. https://doi.org/10.1200/JCO.2007.11.3159