Measurable Residual Disease Assessment and Allogeneic Transplantation as Consolidation Therapy in Adult Acute Lymphoblastic Leukemia in Colombia

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 21; no. 4; pp. e365 - e372
• Main Authors: Combariza, Juan Felipe, Arango, Marcos, Díaz, Laura, Agudelo, Claudia, Hernandez, Sonia, Madera, Ana María, León, Guillermo, Avila, Vladimir, Bautista, Leonardo, Valdés, Jaime, Orduz, Rocio, Mejía, Fabian, Moreno, Liliana, Ramirez, Carlos
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2021
• Subjects: Acute lymphoblastic leukemia; Adolescent; Adult; Aged; Colombia - epidemiology; Consolidation Chemotherapy - methods; Disease free survival; Female; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; Humans; Induction Chemotherapy - methods; Male; Measurable residual disease; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasm, Residual; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Prognosis; Retrospective Studies; Transplantation, Homologous; Young Adult; Colombia; Prognosis; Acute lymphoblastic leukemia; Measurable residual disease; Disease free survival; Hematopoietic stem-cell transplantation
• ISSN: 2152-2650; 2152-2669; 2152-2669
• DOI: 10.1016/j.clml.2020.11.010

Detectable minimal residual disease (MRD) after therapy for acute lymphoblastic leukemia (ALL) is the strongest predictor of hematologic relapse. The objective of the study was to assess disease-free survival (DFS) and overall survival (OS) of patients with ALL according with MRD status at the end of induction therapy in a Colombian population. We assessed a retrospective cohort to compare DFS and OS in adults with de novo ALL according to MRD status at the end of induction chemotherapy, and the type of postinduction consolidation strategy used. A total of 165 adults with ALL were included in the MRD part of the study, 73 patients in the MRD-negative group and 92 in the MRD-positive group. Median DFS for the MRD-positive group was 11 months (95% confidence interval, 11.7-22.2) and was not reached for the MRD-negative group (P < .001). At 3 years, DFS was 18% and 55%, respectively (P < .001). The median OS for MRD-positive patients was 16 months (95% confidence interval, 8.8-23.15) and was not reached in the MRD-negative group. At 3 years, OS was 26% and 51% for the former and latter group, respectively. Among subjects who did not receive a transplant, median DFS was 21 months for MRD-negative patients and 9 months for MRD-positive patients (P < .001). The median DFS was not reached in either group, whereas 3-year DFS was 64% for MRD-negative and 70% for MRD-positive patients who underwent transplantation in first remission (P = .861). MRD status at the end of induction is an independent prognostic factor for DFS and OS in adult ALL. Allogeneic transplantation in first remission could overcome the adverse prognostic impact of MRD. A retrospective assessment of disease-free survival (DFS) and overall survival (OS) of adults with acute lymphoblastic leukemia (ALL) according to minimal residual disease (MRD) status at the end of induction therapy in a Colombian population found that MRD status was an independent prognostic factor for DFS and OS in ALL. Allogeneic transplantation in first remission could overcome the adverse prognostic impact of MRD.