KEY TAKEAWAYS
- The study aimed to investigate the impact of sustained MRD negativity and the choice of post-remission therapy on clinical outcomes in adult patients with B-ALL.
- Researchers noticed that sustained MRD negativity predicts excellent long-term outcomes without allo-HSCT, while allo-HSCT significantly benefits OS and DFS.
To explore the effects of monitoring measurable residual disease (MRD) and post-remission treatment selection on the clinical outcomes of B-cell acute lymphoblastic leukemia (B-ALL) in adults.
Jiechen Yu and the team aimed to assess the impact of sustained MRD negativity and the choice of post-remission therapy on clinical outcomes in adult patients with B-ALL.
They performed an inclusive analysis between September 2010 and January 2022 on adult patients with B-ALL who received combination chemotherapy, with or without allogeneic hematopoietic stem cell transplantation (allo-HSCT). This retrospective study was approved by the Ethics Committee and adhered to the conditions of the Declaration of Helsinki.
About 143 B-ALL patients who achieved complete remission (CR) were included in the study, of whom 94 patients (65.7%) received allo-HSCT in their first complete remission (CR1). Multivariate analysis showed that the most powerful factors affecting overall survival (OS) were transplantation (hazard ratio [HR] = 0.540, P = 0.037) and sustained MRD negativity (HR = 0.508, P = 0.037).
The subgroup analysis indicated that the prognosis of the allo-HSCT group was better than that of the chemotherapy group, regardless of whether MRD was negative or positive after two courses of consolidation therapy. After consolidation therapy, the prognosis of patients with positive MRD remained significantly better in the allo-HSCT group than in the chemotherapy group.
However, no significant difference was observed in the prognosis between the allo-HSCT and chemotherapy groups with negative MRD after consolidation therapy.
The study concluded that B-ALL patients who achieve sustained MRD negativity during consolidation therapy have excellent long-term outcomes even without allo-HSCT. Allo-HSCT is associated with a significant benefit in terms of OS and disease-free survival (DFS) for patients with positive MRD during consolidation therapy.
The study received no funding.
Source: https://pubmed.ncbi.nlm.nih.gov/38785213/
Yu J, Luo Y, Wang L, et al. (2024). “Effect of sustained measurable residue disease negativity and post-remission treatment selection on the prognosis of acute lymphoblastic leukemia in adults.” Cancer Med. 2024 May;13(10):e7310. doi: 10.1002/cam4.7310. PMID: 38785213; PMCID: PMC11117453.
