Prognostic significance of minimal residual disease prior to reinduction in intermediate risk patients with ALL

Occurrence of relapse still remains one of the major therapeutic challenges in the treatment of ALL. The evidence of MRD in the early phase of therapy has shown to be highly predictive for the risk of relapse and has been used for risk stratification for the last two decades. This also concerns the large group of patients with intermediate-risk ALL (MR), where we still observe the highest number of relapses in absolute terms despite favorable overall outcome. The aim of this study was to evaluate the prognostic significance of MRD positivity prior to reinduction therapy in MR patients.A number of 66 MR patients who were treated according to the AIEOP-BFM ALL 2000 protocol were included in this analysis. Bone marrow samples obtained prior to reinduction were analyzed by RQ-PCR of clone-specific junctional regions of immunoglobulin and T-cell receptor gene rearrangements identified at time of diagnosis. MRD-positivity prior to reinduction was associated with significantly higher risk of relapse and reduced overall survival compared to MRD-negative patients. The measurement of MRD prior to reinduction could contribute decisively to the identification of MR patients at risk of relapse.

Publication History

Article published online:
17 May 2022