In a nutshell
This study aimed to investigate minimal residual disease (MRD) levels on the outcomes of children with very low-risk (VLR) acute lymphoblastic leukemia (ALL) treated with reduced intensity therapy.
This study concluded that patients who had a low level of MRD had good outcomes with reduced intensity therapy.
Some background
About 40% of children with ALL are cured with less intensive antimetabolite chemotherapy regimens. Antimetabolites are similar to normal substances in the cells but they help to stop the division of cells and therefore the growth of cancer.
However, identifying patients with VLR-ALL who may benefit from reduced intensity treatments remains imprecise. It is thought that measuring minimal residual disease (MRD) may assist in identifying these patients. MRD refers to the small number of cancer cells that remain after treatment. The lower the MRD, the less risk for cancer relapse there is.
The impact of low MRD levels in remission induction on the outcome of children with VLR ALL treated with low-intensity treatment was unknown.
Methods & findings
This study involved 200 children with ALL. All patients received reduced-intensity therapy. All patients had MRD levels in the bone marrow of less than 0.01% on day 19 of treatment, and at the end of therapy (day 28). The average follow-up was 76 months.
98.5% of the patients were in complete remission after an average of 30 days. 89.5% of patients were alive without complications from ALL after 5 years. Overall, 7% of patients relapsed during 5 years. The 5-year overall survival rate was 95.5%.
14.5% of patients had MRD levels between 0.001% and less than 0.01% on day 19. These patients had a 5-year risk of relapse of 17.2% compared to 5.3% for the patients with undetectable residual leukaemia (no disease detected after treatment).
The bottom line
This study concluded that children with VLR ALL who had a low level of MRD had good outcomes with reduced intensity therapy.
Published By :
Blood
Date :
Jan 07, 2021
