Dynamics of minimal residual disease defines a novel risk-classification and the role of allo-HSCT in adult Ph-negative B-cell acute lymphoblastic leukemia. Issue 13 (10th November 2022)

• Record Type: Journal Article
• Authors: Cai, Zihong; Liu, Yiqian; Tang, Bingqing; Wu, Zhengwei; Wang, Zhixiang; Lin, Ren; Xu, Xiuli; Huang, Zicong; Ou, Jiawang; Li, Xiaofang; Liu, Xiaoli; Liu, Qifa; Zhou, Hongsheng
• Is Part Of: Leukemia & lymphoma. Volume 63:Issue 13(2022)
• Page Start: 3181
• Page End: 3190
• Publication Date: 2022-11-10
• Subjects: Minimal residual disease -- Philadelphia chromosome-negative -- adult B-cell acute lymphoblastic leukemia -- allogeneic hematopoietic stem cell transplantation; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2022.2115841
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: The prognosis of minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL) patients is well established. However, the implementation of dynamic MRD for risk classification and decision-making for allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains vague. In this study, we collected multiparameter flow cytometry (MFC)-MRD data of Ph-negative B-ALL patients ( n = 134) from the Precision-Classification-Directed-Target-Total-Therapy-ALL-2016 (PDT-ALL-2016) cohort and stratified it into high-(HR), medium-(MR), and standard-risk (SR) groups. With a median of 3.65 years follow-up (95% CI: 3.037–4.263), 3-year OS rate was 51.8 ± 8.3% in HR, compared with MR 61.5 ± 10.8% ( p = 0.472), and SR 73.3 ± 5.9% ( p = 0.006). Multivariate analysis shows that integrated dynamic MRD is an independent factor for overall survival. Compared to pediatric-inspired chemotherapy, allo-HSCT significantly improves the survival of the HR cohort ( p < 0.001), but not in MR and SR. Finally, our study suggests that integrated dynamic MRD defines a novel risk-classification criteria and highlights the benefits of allo-HSCT in adult patients with Ph-negative ALL.