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Minimal Residual Disease

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

Bone Marrow Transplantation volume 45, pages 1095–1101 (2010)Cite this article

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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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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