タナカ ジユンジ   TANAKA Junji
  田中 淳司
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Measurable residual disease affects allogeneic hematopoietic cell transplantation in Ph+ ALL during both CR1 and CR2.
掲載誌名 正式名:Blood advances
略  称:Blood Adv
ISSNコード:24739537/24739529
掲載区分国外
巻・号・頁 5(2),pp.584-592
著者・共著者 Nishiwaki Satoshi†, Akahoshi Yu, Mizuta Shuichi, Shinohara Akihito, Hirabayashi Shigeki, Noguchi Yuma, Fukuda Takahiro, Uchida Naoyuki, Tanaka Masatsugu, Onizuka Makoto, Ozawa Yukiyasu, Ota Shuichi, Shiratori Souichi, Onishi Yasushi, Kanda Yoshinobu, Sawa Masashi, Tanaka Junji, Atsuta Yoshiko, Kako Shinichi
発行年月 2021/01
概要 Although measurable residual disease (MRD) at the time of allogeneic hematopoietic cell transplantation (allo-HCT) has been reported to be an important prognostic factor for Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL) during first complete remission (CR1), the prognostic impact of MRD is unclear during second CR (CR2). To clarify the impact of MRD for both CR1 and CR2, we analyzed data from a registry database including 1625 adult patients with Ph+ ALL who underwent first allo-HCT during either CR1 or CR2 between 2002 and 2017. Adjusted overall and leukemia-free survival rates at 4 years were 71% and 64%, respectively, for patients undergoing allo-HCT during CR1 with MRD-, 55% and 43% during CR1 with MRD+, 51% and 49% during CR2 with MRD-, and 38% and 29% during CR2 with MRD+. Although survival rates were significantly better among patients with CR1 MRD- than among patients with CR2 MRD-, no significant difference was observed in survival rate between patients with CR1 MRD+ and CR2 MRD-. Relapse rates after 4 years were 16% in patients with CR1 MRD-, 29% in CR1 MRD+, 21% in patients with CR2 MRD-, and 46% in patients with CR2 MRD+. No significant difference was identified in relapse rate between patients with CR1 MRD- and CR2 MRD-. CR2 MRD- was not a significant risk factor for relapse in multivariate analysis (hazard ratio, 1.26; 95% confidence interval, 0.69-2.29; P = .45 vs CR1 MRD-). MRD at time of allo-HCT was an important risk factor in patients with Ph+ ALL during both CR1 and CR2.
DOI 10.1182/bloodadvances.2020003536
PMID 33496752