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ACUTE LYMPHOBLASTIC LEUKEMIA

A simple algorithm with one flow cytometric MRD measurement identifies more than 40% of children with ALL who can be cured with low-intensity therapy. The ALL-MB 2008 trial results

Leukemia volume 36, pages 1382–1385 (2022)Cite this article

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In the last few decades, increasing therapy intensity has been the most important tool to improve the survival of children with acute lymphoblastic leukemia (ALL) [1, 2]. Yet, we are dealing with acute treatment-related morbidity and mortality and long-term consequences [3, 4]. Therefore, it would be desirable to reduce the intensity of the treatment and thus also the frequency of long-term effects. The lack of reliable criteria for selecting patients with an extremely low likelihood of recurrence was seen as a major obstacle to such de-escalation of treatment. Measurement and monitoring of minimal residual disease (MRD) has proven to be the strongest outcome predictor [5,6,7] and is used in many ALL protocols today, sometimes at multiple time points [7, 8].

Here, we describe a very simple procedure, based on the MRD measurement by multicolor flow cytometry (MFC-MRD), to identify initially standard-risk children with a particularly favorable prognosis who were treated curatively with a low-dose therapy regimen.

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Fig. 1: Event-free survival (EFS, solid lines) and cumulative incidence of relapse (CIR, dashed lines) according to MFC-MRD values.

Data availability

For original data, please contact uralcytometry@gmail.com.

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Acknowledgements

The authors thank all doctors, nurses and laboratory personel in participating institutions, who were involved in patients diagnostics, management and monitoring. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Olga Aleinikova

    Present address: National Research and Clinical Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation

  2. These authors contributed equally: Alexander Popov, Guenter Henze.

Authors and Affiliations

  1. National Research and Clinical Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation

    Alexander Popov, Julia Roumiantseva, Oleg Budanov, Maria Fadeeva, Svetlana Lagoyko, Liudmila Zharikova, Natalia Miakova, Dmitry Litvinov, Galina Novichkova & Alexander Karachunskiy

  2. Department of Pediatric Oncology Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Guenter Henze

  3. Belarussian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus

    Oleg Budanov, Mikhail Belevtsev, Liudmila Movchan, Elena Stolyarova & Olga Aleinikova

  4. Regional Children’s Hospital, Ekaterinburg, Russian Federation

    Tatiana Verzhbitskaya, Grigory Tsaur, Olga Khlebnikova, Olga Streneva & Larisa Fechina

  5. Research Institute of Medical Cell Technologies, Ekaterinburg, Russian Federation

    Tatiana Verzhbitskaya, Grigory Tsaur, Olga Streneva & Larisa Fechina

  6. Moscow City Blood Center named after OK Gavrilov, Moscow, Russian Federation

    Elena Boyakova

  7. Republican Children’s Hospital, Moscow, Russian Federation

    Natalia Ponomareva

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  1. Alexander Popov
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Contributions

AP – concept and design of the study, MFC-MRD data, data analysis and interpretation, writing the paper. GH – concept and design of the study, data analysis and interpretation, writing the paper. JR – database handling, data analysis and interpretation, writing the paper. OB – database handling, statistics. MB – MFC-MRD data. TV – MFC-MRD data. EB – MFC-MRD data. LM – MFC-MRD data. GT – data analysis and interpretation. MF – MFC-MRD data. SL – database handling, data analysis. LZh – database handling, data analysis. NM – patients data. DL – patients data. OKh – patients data. OS – patients data. ES – patients data. NP – patients data. GN – concept and design of the study, general supervising, writing the paper. LF – concept and design of the study, general supervising, writing the paper. OA – concept and design of the study, general supervising, writing the paper. AK – concept and design of the study, data analysis and interpretation, general supervising, writing the paper. AP and GH contributed equally to this work. All authors have read and approved the final version of manuscript.

Corresponding author

Correspondence to Alexander Popov.

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Popov, A., Henze, G., Roumiantseva, J. et al. A simple algorithm with one flow cytometric MRD measurement identifies more than 40% of children with ALL who can be cured with low-intensity therapy. The ALL-MB 2008 trial results. Leukemia 36, 1382–1385 (2022). https://doi.org/10.1038/s41375-022-01542-z

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