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Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study.

Publication ,  Journal Article
Borowitz, MJ; Devidas, M; Hunger, SP; Bowman, WP; Carroll, AJ; Carroll, WL; Linda, S; Martin, PL; Pullen, DJ; Viswanatha, D; Willman, CL ...
Published in: Blood
June 15, 2008

Minimal residual disease (MRD) is an important predictor of relapse in acute lymphoblastic leukemia (ALL), but its relationship to other prognostic variables has not been fully assessed. The Children's Oncology Group studied the prognostic impact of MRD measured by flow cytometry in the peripheral blood at day 8, and in end-induction (day 29) and end-consolidation marrows in 2143 children with precursor B-cell ALL (B-ALL). The presence of MRD in day-8 blood and day-29 marrow MRD was associated with shorter event-free survival (EFS) in all risk groups; even patients with 0.01% to 0.1% day-29 MRD had poor outcome compared with patients negative for MRD patients (59% +/- 5% vs 88% +/- 1% 5-year EFS). Presence of good prognostic markers TEL-AML1 or trisomies of chromosomes 4 and 10 still provided additional prognostic information, but not in National Cancer Institute high-risk (NCI HR) patients who were MRD(+). The few patients with detectable MRD at end of consolidation fared especially poorly, with only a 43% plus or minus 7% 5-year EFS. Day-29 marrow MRD was the most important prognostic variable in multi-variate analysis. The 12% of patients with all favorable risk factors, including NCI risk group, genetics, and absence of days 8 and 29 MRD, had a 97% plus or minus 1% 5-year EFS with nonintensive therapy. These studies are registered at www.clinicaltrials.gov as NCT00005585, NCT00005596, and NCT00005603.

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Published In

Blood

DOI

EISSN

1528-0020

Publication Date

June 15, 2008

Volume

111

Issue

12

Start / End Page

5477 / 5485

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Recurrence
  • Proportional Hazards Models
  • Prognosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oncogene Proteins, Fusion
  • Neoplasm, Residual
  • Multivariate Analysis
  • Immunology
 

Citation

APA
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ICMJE
MLA
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Borowitz, M. J., Devidas, M., Hunger, S. P., Bowman, W. P., Carroll, A. J., Carroll, W. L., … Children’s Oncology Group, . (2008). Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study. Blood, 111(12), 5477–5485. https://doi.org/10.1182/blood-2008-01-132837
Borowitz, Michael J., Meenakshi Devidas, Stephen P. Hunger, W Paul Bowman, Andrew J. Carroll, William L. Carroll, Stephen Linda, et al. “Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study.Blood 111, no. 12 (June 15, 2008): 5477–85. https://doi.org/10.1182/blood-2008-01-132837.
Borowitz, Michael J., et al. “Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study.Blood, vol. 111, no. 12, June 2008, pp. 5477–85. Pubmed, doi:10.1182/blood-2008-01-132837.
Borowitz MJ, Devidas M, Hunger SP, Bowman WP, Carroll AJ, Carroll WL, Linda S, Martin PL, Pullen DJ, Viswanatha D, Willman CL, Winick N, Camitta BM, Children’s Oncology Group. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study. Blood. 2008 Jun 15;111(12):5477–5485.

Published In

Blood

DOI

EISSN

1528-0020

Publication Date

June 15, 2008

Volume

111

Issue

12

Start / End Page

5477 / 5485

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Recurrence
  • Proportional Hazards Models
  • Prognosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oncogene Proteins, Fusion
  • Neoplasm, Residual
  • Multivariate Analysis
  • Immunology