Impact of pretransplant minimal residual disease after cord blood transplantation for childhood acute lymphoblastic leukemia in remission: an Eurocord, PDWP-EBMT analysis

Leukemia
A RuggeriVanderson Rocha

Abstract

To address the prognostic value of minimal residual disease (MRD) before unrelated cord blood transplantation (UCBT) in children with acute lymphoblastic leukemia (ALL), we analyzed 170 ALL children transplanted in complete remission (CR) after myeloablative conditioning regimen. In all, 72 (43%) were in first CR (CR1), 77 (45%) in second CR (CR2) and 21 (12%) in third CR (CR3). The median interval from MRD quantification to UCBT was 18 days. All patients received single-unit UCBT. Median follow-up was 4 years. Cumulative incidence (CI) of day-60 neutrophil engraftment was 85%. CI of 4 years relapse was 30%, incidence being lower in patients with negative MRD before UCBT (hazard ratio (HR)=0.4, P=0.01) and for those transplanted in CR1 and CR2 (HR=0.3, P=0.002). Probability of 4 years leukemia-free survival (LFS) was 44%, (56, 44 and 14% for patients transplanted in CR1, CR2 and CR3, respectively (P=0.0001)). Patients with negative MRD before UCBT had better LFS after UCBT compared with those with positive MRD (54% vs 29%; HR=2, P=0.003). MRD assessment before UCBT for children with ALL in remission allows identifying patients at higher risk of relapse after transplantation. Approaches that may decrease relapse incidence in chi...Continue Reading

References

Aug 27, 1998·The New England Journal of Medicine·C H Pui, W E Evans
Mar 6, 2002·Blood·Michael N DworzakUNKNOWN Austrian Berlin-Frankfurt-Münster Study Group
Apr 26, 2006·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Paul J MartinUNKNOWN Design of Clinical Trials Working Group
Dec 18, 2007·Bone Marrow Transplantation·V Rocha, F Locatelli
Mar 20, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Caroline OudotAndré Baruchel
Dec 10, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Peter BaderUNKNOWN ALL-REZ BFM Study Group
Jan 29, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Michael A PulsipherLaurence J N Cooper
Oct 7, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Giuseppe BassoGiuseppe Gaipa
Sep 15, 2010·Best Practice & Research. Clinical Haematology·Vanderson RochaUNKNOWN Eurocord Registry
Sep 30, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Maurizio AricòMaria Grazia Valsecchi
Nov 30, 2010·Best Practice & Research. Clinical Haematology·Elaine Coustan-Smith, Dario Campana
Jan 18, 2011·Hematology·Dario Campana
Feb 2, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Roland B WalterJohn M Pagel
Jul 7, 2011·Blood·Irene HommingaJules P P Meijerink

❮ Previous
Next ❯

Citations

Mar 24, 2016·Seminars in Hematology·Annalisa Ruggeri
Mar 5, 2014·British Journal of Haematology·Peter LangRupert Handgretinger
Sep 8, 2016·The New England Journal of Medicine·Filippo MilanoColleen Delaney
Dec 27, 2018·Current Opinion in Pediatrics·Agne Taraseviciute, Michael A Pulsipher
Jun 13, 2020·Expert Opinion on Biological Therapy·Mattia AlgeriFranco Locatelli
Aug 18, 2018·Bone Marrow Transplantation·Marco LadettoPeter Bader
Dec 7, 2019·Hematology·Annalisa Ruggeri

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.