TY - JOUR
T1 - Molecular response with blinatumomab in relapsed/refractory B-cell precursor acute lymphoblastic leukemia
AU - Gökbuget, Nicola
AU - Kantarjian, Hagop M.
AU - Brüggemann, Monika
AU - Stein, Anthony S.
AU - Bargou, Ralf C.
AU - Dombret, Hervé
AU - Fielding, Adele K.
AU - Heffner, Leonard
AU - Rigal-Huguet, Françoise
AU - Litzow, Mark
AU - O’Brien, Susan
AU - Zugmaier, Gerhard
AU - Gao, Shan
AU - Nagorsen, Dirk
AU - Forman, Stephen J.
AU - Topp, Max S.
N1 - Publisher Copyright:
© 2019 by The American Society of Hematology
PY - 2019/10/22
Y1 - 2019/10/22
N2 - Minimal residual disease (MRD), where leukemic cell levels are lower than the morphologic detection threshold, is the most important prognostic factor for acute lymphoblastic leukemia (ALL) relapse during first-line chemotherapy treatment and is standard of care in treatment monitoring and decision making. Limited data are available on the prognostic value of MRD response after relapse. We evaluated the relationship between MRD response and outcomes in blinatumomab-treated adults with relapsed/refractory (R/R) B-cell precursor ALL. Of 90 patients with complete remission (CR) or CR with partial hematologic recovery (CRh), 64 (71.1%) achieved a complete MRD response (no detectable individual rearrangements of immunoglobulin/T-cell receptor genes by polymerase chain reaction [PCR] at a minimum sensitivity level of 1024). Eleven patients had MRD,1024. Therefore, overall, 75 (83.3%) experienced an MRD response (no detectable MRD or detectable MRD) measured by PCR within the first 2 treatment cycles. Overall survival (OS) and relapse-free survival (RFS) were significantly longer in patients who achieved CR/CRh and MRD response (median, 20.6 and 9.0 months, respectively) compared with CR/CRh patients without MRD response (median, 12.5 and 2.3 months, respectively). In conclusion, longer durations of OS and RFS associated with MRD response support the value of achieving MRD response and its use as a prognostic factor for blinatumomab treatment in R/R ALL. This trial was registered at www.clinicaltrials.gov as #NCT01466179.
AB - Minimal residual disease (MRD), where leukemic cell levels are lower than the morphologic detection threshold, is the most important prognostic factor for acute lymphoblastic leukemia (ALL) relapse during first-line chemotherapy treatment and is standard of care in treatment monitoring and decision making. Limited data are available on the prognostic value of MRD response after relapse. We evaluated the relationship between MRD response and outcomes in blinatumomab-treated adults with relapsed/refractory (R/R) B-cell precursor ALL. Of 90 patients with complete remission (CR) or CR with partial hematologic recovery (CRh), 64 (71.1%) achieved a complete MRD response (no detectable individual rearrangements of immunoglobulin/T-cell receptor genes by polymerase chain reaction [PCR] at a minimum sensitivity level of 1024). Eleven patients had MRD,1024. Therefore, overall, 75 (83.3%) experienced an MRD response (no detectable MRD or detectable MRD) measured by PCR within the first 2 treatment cycles. Overall survival (OS) and relapse-free survival (RFS) were significantly longer in patients who achieved CR/CRh and MRD response (median, 20.6 and 9.0 months, respectively) compared with CR/CRh patients without MRD response (median, 12.5 and 2.3 months, respectively). In conclusion, longer durations of OS and RFS associated with MRD response support the value of achieving MRD response and its use as a prognostic factor for blinatumomab treatment in R/R ALL. This trial was registered at www.clinicaltrials.gov as #NCT01466179.
UR - http://www.scopus.com/inward/record.url?scp=85074926246&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074926246&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2019000457
DO - 10.1182/bloodadvances.2019000457
M3 - Article
C2 - 31648325
AN - SCOPUS:85074926246
SN - 2473-9529
VL - 3
SP - 3033
EP - 3037
JO - Blood Advances
JF - Blood Advances
IS - 20
ER -