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Article: Detectable minimal residual disease before hematopoietic cell transplantation is prognostic but does not preclude cure for children with very-high-risk leukemia

TitleDetectable minimal residual disease before hematopoietic cell transplantation is prognostic but does not preclude cure for children with very-high-risk leukemia
Authors
Issue Date2012
Citation
Blood, 2012, v. 120, n. 2, p. 468-472 How to Cite?
AbstractIn patients with acute leukemia, detection of minimal residual disease (MRD) before allogeneic hematopoietic cell transplantation (HCT) correlates with risk of relapse. However, the level of MRD that is most likely to preclude cure by HCT is unclear, and the benefit of further chemotherapy to reduce MRD before HCT is unknown. In 122 children with very-high-risk acute lymphoblastic leukemia (ALL; n = 64) or acute myeloid leukemia (AML, n = 58), higher MRD levels at the time of HCT predicted a poorer survival after HCT (P = .0019); MRD was an independent prognostic factor in a multivariate analysis (P = .0035). However, the increase in risk of death associated with a similar increment of MRD was greater in ALL than in AML, suggesting that a pretransplantation reduction of leukemia burden would have a higher impact in ALL. At any given MRD level, survival rates were higher for patients treated in recent protocols: the 5-year overall survival for patients with ALL was 49% if MRD was detectable and 88% if it was not and the corresponding rates for patients with AML were 67% and 80%, respectively. Although MRD before HCT is a strong prognostic factor, its impact has diminished and should not be regarded as a contraindication for HCT. © 2012 by The American Society of Hematology.
Persistent Identifierhttp://hdl.handle.net/10722/294454
ISSN
2020 Impact Factor: 22.113
2015 SCImago Journal Rankings: 6.395
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, Wing-
dc.contributor.authorPui, Ching Hon-
dc.contributor.authorCoustan-Smith, Elaine-
dc.contributor.authorYang, Jie-
dc.contributor.authorPei, Deqing-
dc.contributor.authorGan, Kwan-
dc.contributor.authorSrinivasan, Ashok-
dc.contributor.authorHartford, Christine-
dc.contributor.authorTriplett, Brandon M.-
dc.contributor.authorDallas, Mari-
dc.contributor.authorPillai, Asha-
dc.contributor.authorShook, David-
dc.contributor.authorRubnitz, Jeffrey E.-
dc.contributor.authorSandlund, John T.-
dc.contributor.authorJeha, Sima-
dc.contributor.authorInaba, Hiroto-
dc.contributor.authorRibeiro, Raul C.-
dc.contributor.authorHandgretinger, Rupert-
dc.contributor.authorLaver, Joseph H.-
dc.contributor.authorCampana, Dario-
dc.date.accessioned2020-12-03T08:22:46Z-
dc.date.available2020-12-03T08:22:46Z-
dc.date.issued2012-
dc.identifier.citationBlood, 2012, v. 120, n. 2, p. 468-472-
dc.identifier.issn0006-4971-
dc.identifier.urihttp://hdl.handle.net/10722/294454-
dc.description.abstractIn patients with acute leukemia, detection of minimal residual disease (MRD) before allogeneic hematopoietic cell transplantation (HCT) correlates with risk of relapse. However, the level of MRD that is most likely to preclude cure by HCT is unclear, and the benefit of further chemotherapy to reduce MRD before HCT is unknown. In 122 children with very-high-risk acute lymphoblastic leukemia (ALL; n = 64) or acute myeloid leukemia (AML, n = 58), higher MRD levels at the time of HCT predicted a poorer survival after HCT (P = .0019); MRD was an independent prognostic factor in a multivariate analysis (P = .0035). However, the increase in risk of death associated with a similar increment of MRD was greater in ALL than in AML, suggesting that a pretransplantation reduction of leukemia burden would have a higher impact in ALL. At any given MRD level, survival rates were higher for patients treated in recent protocols: the 5-year overall survival for patients with ALL was 49% if MRD was detectable and 88% if it was not and the corresponding rates for patients with AML were 67% and 80%, respectively. Although MRD before HCT is a strong prognostic factor, its impact has diminished and should not be regarded as a contraindication for HCT. © 2012 by The American Society of Hematology.-
dc.languageeng-
dc.relation.ispartofBlood-
dc.titleDetectable minimal residual disease before hematopoietic cell transplantation is prognostic but does not preclude cure for children with very-high-risk leukemia-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1182/blood-2012-02-409813-
dc.identifier.pmid22517895-
dc.identifier.pmcidPMC3398757-
dc.identifier.scopuseid_2-s2.0-84864047454-
dc.identifier.volume120-
dc.identifier.issue2-
dc.identifier.spage468-
dc.identifier.epage472-
dc.identifier.eissn1528-0020-
dc.identifier.isiWOS:000307412400032-
dc.identifier.f1000717950300-
dc.identifier.issnl0006-4971-

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