Clinical significance of minimal residual disease in adult acute lymphoblastic leukemia.
Monitoring minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL) is a useful way for assessing treatment response and relapse. We studied the value of MRD and showed a correlation with relapse for 34 adult patients with ALL. MRD was evaluated by real-time quantitative polymerase chain reaction (RQ-PCR) with probes derived from fusion chimeric genes (BCR/ABL) (n = 12) or PCR-based detection of clonal immunoglobulin and T cell receptor gene rearrangements (n = 16), or both (n = 6). We analyzed 27 of the 34 patients who could be examined for MRD on day 100 after induction therapy. The overall survival (OS) rate (45.0%) and relapse-free survival (RFS) rate (40.0%) at 2 years in complete remission (CR) patients with MRD level ≥ 10⁻³ (n = 12) were significantly lower than those in CR patients with MRD level <10(-3) (n = 15) (OS rate 79.0%, RFS rate 79.4%) (log-rank test, P = 0.017 and 0.0007). We also applied multicolor flow cytometry for comparison with MRD results analyzed by PCR methods. The comparison of results obtained in 27 follow-up samples showed consistency in 17 samples (63.0%) (P = 0.057). MRD analysis on day 100 is important for treatment decision in adult ALL.
Kikuchi
Misato
M
Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, 060-8648, Japan.
Tanaka
Junji
J
Kondo
Takeshi
T
Hashino
Satoshi
S
Kasai
Masaharu
M
Kurosawa
Mitsutoshi
M
Iwasaki
Hiroshi
H
Morioka
Masanobu
M
Kawamura
Tsugumichi
T
Masauzi
Nobuo
N
Fukuhara
Takashi
T
Kakinoki
Yasutaka
Y
Kobayashi
Hajime
H
Noto
Satoshi
S
Asaka
Masahiro
M
Imamura
Masahiro
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D016133:Polymerase Chain Reaction; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000517:prevention & control* / Q000601:surgery / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014184:Transplantation, Homologous; D055815:Young Adult