In a nutshell
This study aimed to investigate the assessment of undetectable minimal residual disease in patients with chronic lymphocytic leukemia after venetoclax treatment.
This study concluded that in these patients, peripheral blood and bone marrow undetectable minimal residual disease assessments are comparable.
Some background
Venetoclax (Venclexta) is a drug used to treat chronic lymphocytic leukemia (CLL). It achieves deep responses in patients with relapsed/refractory (R/R) CLL including undetectable minimal residual disease (uMRD). MRD is the small number of cancer cells left after treatment. When this is undetectable a patient is said to be in remission. uMRD can be assessed from the bone marrow (BM) or peripheral blood (PB).
It was unknown if BM or PB uMRD assessments were better for patients with R/R CLL treated with venetoclax.
Methods & findings
This study involved 62 patients with CLL who received venetoclax treatment. MRD status was assessed at least once.
Of the 16 patients who achieved PB uMRD and had BM assessments at the same time, 81% had confirmed BM uMRD. Patients with PB uMRD had outcomes as favorable as those with BM uMRD for time to progression, overall survival (OS) and MRD recurrence.
The average time to PB uMRD was 18 months and 90% of these were achieved by 24 months. There were no new cases of PB uMRD after 24 months unless treatment was intensified.
Patients who received rituximab (Rituxan) at the same time as venetoclax had an earlier achievement of uMRD. 27% of patients who received venetoclax dose escalations had improved responses.
The bottom line
This study concluded that in patients with R/R CLL treated with venetoclax, PB and BM uMRD assessments are comparable.
The fine print
This study looked at medical records. Some data might have been missing. Further controlled studies are needed for stronger evidence.
Published By :
Blood advances
Date :
Jan 14, 2020
