TANAKA Junji
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Measurable residual disease affects allogeneic hematopoietic cell transplantation in Ph+ ALL during both CR1 and CR2.
Journal Formal name:Blood advances
Abbreviation:Blood Adv
ISSN code:24739537/24739529
Domestic / ForeginForegin
Volume, Issue, Page 5(2),pp.584-592
Author and coauthor 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
Publication date 2021/01
Summary 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