TANAKA Junji
Department Other, Other Position |
|
Article types | Original article |
Language | English |
Peer review | Peer reviewed |
Title | Minimal residual disease (MRD) positivity at allogeneic hematopoietic cell transplantation, not the quantity of MRD, is a risk factor for relapse of Philadelphia chromosome-positive acute lymphoblastic leukemia. |
Journal | Formal name:International journal of hematology Abbreviation:Int J Hematol ISSN code:18653774/09255710 |
Domestic / Foregin | Foregin |
Volume, Issue, Page | 113(6),pp.832-839 |
Author and coauthor | Akahoshi Yu†, Arai Yasuyuki, Nishiwaki Satoshi, Mizuta Shuichi, Marumo Atsushi, Uchida Naoyuki, Kanda Yoshinobu, Sakai Hitoshi, Takada Satoru, Fukuda Takahiro, Fujisawa Shin, Ashida Takashi, Tanaka Junji, Atsuta Yoshiko, Kako Shinichi |
Publication date | 2021/06 |
Summary | Minimal residual disease (MRD) monitoring by quantitative real-time reverse transcription PCR (qRT-PCR) is the standard of care in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL). We evaluated the impact of MRD status at hematopoietic cell transplantation (HCT) on relapse, as measured by a unified protocol at a central laboratory. Only patients with Ph-positive ALL who had minor transcripts (e1a2) and who underwent allogeneic HCT in first complete remission between 2008 and 2017 were included. First, patients with negative-MRD (n = 196) and positive-MRD (n = 61) at HCT were analyzed. As expected, MRD positivity at HCT was significantly associated with an increased risk of hematological relapse (hazard ratio [HR], 2.91; 95% CI 1.67-5.08; P < 0.001) in the multivariate analysis. Next, patients with positive-MRD were divided into low-MRD (n = 39) and high-MRD (n = 22) groups. In the multivariate analysis, high-MRD at HCT was not significantly associated with an increased risk of hematological relapse compared to the low-MRD group (HR 1.10; 95% CI 0.54-2.83; P = 0.620). These results indicate that the therapeutic decisions should be made based on MRD positivity, rather than on the MRD level, at HCT. |
DOI | 10.1007/s12185-021-03094-x |
PMID | 33570732 |