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Clinical significance of minimal residual disease at day 15 and at the end of therapy in childhood acute lymphoblastic leukaemia
British Journal of Haematology, 06/08/09

Sutton R et al. – Study concludes a strong predictive value of minimal residual disease (MRD) kinetics at day 15; should be validated in a larger patient cohort so that earlier detection of risk of relapse can be assessed. In addition, data also provide evidence that additional late MRD monitoring of patients would enable detection of molecular relapse, which, in combination with salvage therapy, may provide the means to further improve survival rates in children with acute lymphoblastic leukaemia (ALL).

Methods

Aim was to evaluate the prognostic significance of MRD at additional treatment phases
MRD was measured by real-time qPCR on a selected group of 108 pts
36 pts with a bone marrow or central nervous system relapse and 72 matched pts in first remission

Results

MRD was prognostic of outcome at all five treatment phases tested: at day 15, day 35, 4, 12 and 24 mo
Day 15 was the best early MRD time-point to differentiate between pts with high, intermediate and low risk of relapse
MRD testing at 12 and particularly at 24 mo, detected molecular relapses in some pts up to 6 mo before clinical relapse

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