Acute Leukemias - Republican Scientific Medical Library

a 20.3 · MRD Monitoring in Clinical Trials of ALL 253
Table 20.3. Major PCR-based MRD studies
Study N Method Timing Relapse/MRD Major conclusion
Brisco 1996
[76]
Roberts
1997 [60]
Foroni 1997
[64]
Cave 1998
[59]
Van Dongen
1998 [61]
Goulden
1998 [62]
Grumayer
2000 [108]
MRD (+) MRD (–)
27A * IgH/TCR Day 34–43 11/18 3/9
(61%) (33%)
24C* IgH/TCR Up to 5/20 0/2
(Quantita- 35 months (25%) (0%)
tive) after end
of therapy
30A* IgH/TCR After in- 2/5
2/5
(Qualita- duction (40%) (40%)
tive) 3 months 5/8
1/5
(62%) (20%)
6 months 4/5
1/10
(80%) (1%)
12 months 1/2
3/9
(50%) (33%)
178C* IgH/TCR After in- 25/63 7/88
(Quantita- duction (39%) (7%)
tive) After con- 15/32 8/95
solidation (46%) (8%)
6 months 21/38 25/215
after consolidation
(55%) (11%)
240C* IgH/TCR After in- 40/98 2/71
moTAL-1 duction (40%) (2%)
(Qualöita- 4–6
32/47 18/166
tive) months (68%) (10%)
12 months 18/21 14/166
(85%) (8%)
End of 5/6 (83%) 9/148
treatment
(6%)
66C* IgH/TCR After 23/33 5/29
(Qualita- 6 months (69%) (17%)
tive) After end 18/28 6/30
of therapy (64%) (20%)
68C* IgH/TCR Day 15 16/54 0/14
(Qualitative)
(29%) (0%)
ALL in adults is more drug-resistant
than in children
The cure of ALL may not require the
elimination of all leukemia cells
Resolution of MRD in ALL occurs more
rapidly in children compared to adults
Early MRD+ assessment in adult ALL
may not correlate
MRD >1% at the end of induction or
MRD >0.1% at later TP high risk of
relapse
MRD at day 33 and day 78 defines
risk of relapse:
High risk: MRD >1% at day 33 or
MRD >0.1% at day 78
Low risk: MRD