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Minimal Residual Disease

Status of minimal residual disease determines outcome of autologous hematopoietic SCT in adult ALL

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Abstract

The role of autologous hematopoietic SCT (autoHSCT) in the treatment of high-risk (HR) adult ALL is controversial. In this study, we retrospectively analyzed the results of autoHSCT according to the status of minimal residual disease (MRD) at transplantation, as a joint analysis of the European Study Group for Adult ALL (EWALL). Data on 123 recipients of autoHSCT, aged 31 (16–59) years, with B-lineage (n=77) or T-lineage (n=46) ALL were included. In a cohort of Ph-negative ALL, the probability of leukemia-free survival at 5 years was higher for patients with MRD <0.1% compared with those with MRD ⩾0.1% (57 vs 17%, P=0.0002). The difference was significant for T-lineage ALL (62 vs 8%, P=0.001), and a tendency was observed for B-lineage ALL (54 vs 26%, P=0.17). In a multivariate analysis, adjusted for other potential prognostic factors, high MRD level remained the only independent factor associated with increased risk of failure (risk ratio, 2.8; P=0.0005). We conclude that MRD determines the outcome of autoHSCT in HR adult ALL. Our results suggest the need to reevaluate the role of this treatment option in prospective trials.

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Acknowledgements

The contributions of the scientists involved in MRD assessment, Krystyna Jagoda, PhD, Agnieszka Balana-Nowak, PhD, Monika Brüggemann PhD, and Thorsten Raff, PhD, are acknowledged.

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Authors and Affiliations

  1. Department of Clinical and Experimental Oncology, Comprehensive Cancer Centre, Maria Sklodowska-Curie Memorial Institute Branch Gliwice, Gliwice, Poland

    S Giebel & J Holowiecki

  2. Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland

    B Stella-Holowiecka, M Krawczyk-Kulis, T Czerw & S Kyrcz-Krzemien

  3. Department of Hematology, University of Frankfurt, Frankfurt, Germany

    N Gökbuget & D Hoelzer

  4. Department of Internal Medicine, Hemato-Oncology, University Hospital Brno, Brno, Czech Republic

    M Doubek & J Mayer

  5. Department of Hematology, Collegium Medicum, Jagiellonian University, Cracow, Poland

    B Piatkowska-Jakubas & A B Skotnicki

  6. Service d'Hématologie, CHU, Hôpital Saint-Louis, Paris, France

    H Dombret

  7. Department of Clinical Hematology, Institut Catala d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Spain

    J M Ribera

  8. Department of Hematology and Medical Oncology ‘L. and A. Seràgnoli’, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    P P Piccaluga

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  1. S Giebel
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  2. B Stella-Holowiecka
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  3. M Krawczyk-Kulis
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  4. N Gökbuget
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  5. D Hoelzer
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  6. M Doubek
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  7. J Mayer
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  8. B Piatkowska-Jakubas
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  9. A B Skotnicki
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  10. H Dombret
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  11. J M Ribera
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  12. P P Piccaluga
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  13. T Czerw
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  14. S Kyrcz-Krzemien
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  15. J Holowiecki
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on behalf of the Study Group for Adult ALL (EWALL) of the European Leukemia Net

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Correspondence to S Giebel.

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Giebel, S., Stella-Holowiecka, B., Krawczyk-Kulis, M. et al. Status of minimal residual disease determines outcome of autologous hematopoietic SCT in adult ALL. Bone Marrow Transplant 45, 1095–1101 (2010). https://doi.org/10.1038/bmt.2009.308

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  • DOI: https://doi.org/10.1038/bmt.2009.308

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