Clinical value of pre-transplant minimal residual disease in childhood lymphoblastic leukaemia: the results of the French minimal residual disease-guided protocol - Université de Rennes Accéder directement au contenu
Article Dans Une Revue British Journal of Haematology Année : 2014

Clinical value of pre-transplant minimal residual disease in childhood lymphoblastic leukaemia: the results of the French minimal residual disease-guided protocol

Cécile Pochon
Jean-Hugues H. Dalle
  • Fonction : Auteur
Eva De Berranger
  • Fonction : Auteur
Elizabeth Macintyre
Pierre Rorhlich
  • Fonction : Auteur
Patrick Lutz
  • Fonction : Auteur
Marilyne Poirée
  • Fonction : Auteur

Résumé

Minimal residual disease (MRD) is a major predictive factor of the cure rate of acute lymphoblastic leukaemia (ALL). Haematopoietic cell transplantation is a treatment option for patients at high risk of relapse. Between 2005 and 2008, we conducted a prospective study evaluating the feasibility and efficacy of the reduction of immunosuppressive medication shortly after a non-ex vivo T depleted myeloablative transplantation. Immunoglobulin (Ig)H/T-cell receptor MRD 30 d before transplant could be obtained in 122 of the 133 cases of high-risk paediatric ALL enrolled. There were no significant demographic differences except remission status (first or second complete remission) between the 95 children with MRD \textless10(-3) and the 27 with MRD ≥10(-3) . Multivariate analysis identified sex match and MRD as being significantly associated with 5-year survival. MRD ≥10(-3) compromised the 5-year cumulative incidence of relapse (43*6 vs. 16*7%). Complete remission status and stem cell source did not modify the relationship between MRD and prognosis. Thus, pre-transplant MRD is still a major predictor of outcome for ALL. The MRD-guided strategy resulted in survival for 72*3% of patients with MRD\textless10(-3) and 40*4% of those with MRD ≥10(-3).

Dates et versions

hal-01064611 , version 1 (16-09-2014)

Identifiants

Citer

Virginie Gandemer, Cécile Pochon, Emmanuel Oger, Jean-Hugues H. Dalle, Gérard Michel, et al.. Clinical value of pre-transplant minimal residual disease in childhood lymphoblastic leukaemia: the results of the French minimal residual disease-guided protocol. British Journal of Haematology, 2014, 165 (3), pp.392--401. ⟨10.1111/bjh.12749⟩. ⟨hal-01064611⟩
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