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Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study

Bergfelt, Emma; Kozlowski, Piotr; Ahlberg, Lucia; Hulegardh, Erik; Hagglund, Hans; Karlsson, Karin LU ; Markuszewska-Kuczymska, Alicja; Tomaszewska-Toporska, Beata; Smedmyr, Bengt and Astrom, Maria, et al. (2015) In Medical Oncology 32(4). p.135-135
Abstract
The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status... (More)
The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status >= 2. MRD < 0.1 % after induction had positive impact on continuous complete remission but not on OS. Only five patients were allocated to allogeneic haematopoietic stem cell transplantation in first remission, mainly due to conventional high risk factors. Thus, use of intensive remission induction therapy is effective in a selection of older patients. In a population for whom the possibilities of treatment escalation are limited, the optimal role of MRD monitoring remains to be determined. (Less)
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publication status
published
subject
keywords
Acute lymphoblastic leukaemia, Adults, Minimal residual disease, Flow, cytometry
in
Medical Oncology
volume
32
issue
4
pages
135 - 135
publisher
Humana Press
external identifiers
  • wos:000351474100049
  • scopus:84938087842
ISSN
1559-131X
DOI
10.1007/s12032-015-0582-2
language
English
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yes
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aa1d70c2-4e0a-4130-a7c4-a1a0c39e9f24 (old id 5281957)
date added to LUP
2015-05-04 08:53:45
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2017-01-01 05:38:16
@article{aa1d70c2-4e0a-4130-a7c4-a1a0c39e9f24,
  abstract     = {The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status &gt;= 2. MRD &lt; 0.1 % after induction had positive impact on continuous complete remission but not on OS. Only five patients were allocated to allogeneic haematopoietic stem cell transplantation in first remission, mainly due to conventional high risk factors. Thus, use of intensive remission induction therapy is effective in a selection of older patients. In a population for whom the possibilities of treatment escalation are limited, the optimal role of MRD monitoring remains to be determined.},
  author       = {Bergfelt, Emma and Kozlowski, Piotr and Ahlberg, Lucia and Hulegardh, Erik and Hagglund, Hans and Karlsson, Karin and Markuszewska-Kuczymska, Alicja and Tomaszewska-Toporska, Beata and Smedmyr, Bengt and Astrom, Maria and Amini, Rose-Marie and Hallbook, Helene},
  issn         = {1559-131X},
  keyword      = {Acute lymphoblastic leukaemia,Adults,Minimal residual disease,Flow,cytometry},
  language     = {eng},
  number       = {4},
  pages        = {135--135},
  publisher    = {Humana Press},
  series       = {Medical Oncology},
  title        = {Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study},
  url          = {http://dx.doi.org/10.1007/s12032-015-0582-2},
  volume       = {32},
  year         = {2015},
}