Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study

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Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study. / Bergfelt, Emma; Kozlowski, Piotr; Ahlberg, Lucia; Hulegardh, Erik; Hagglund, Hans; Karlsson, Karin; Markuszewska-Kuczymska, Alicja; Tomaszewska-Toporska, Beata; Smedmyr, Bengt; Astrom, Maria; Amini, Rose-Marie; Hallbook, Helene.

In: Medical Oncology, Vol. 32, No. 4, 2015, p. 135.

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Bergfelt, E, Kozlowski, P, Ahlberg, L, Hulegardh, E, Hagglund, H, Karlsson, K, Markuszewska-Kuczymska, A, Tomaszewska-Toporska, B, Smedmyr, B, Astrom, M, Amini, R-M & Hallbook, H 2015, 'Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study', Medical Oncology, vol. 32, no. 4, pp. 135. https://doi.org/10.1007/s12032-015-0582-2

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Bergfelt, Emma ; Kozlowski, Piotr ; Ahlberg, Lucia ; Hulegardh, Erik ; Hagglund, Hans ; Karlsson, Karin ; Markuszewska-Kuczymska, Alicja ; Tomaszewska-Toporska, Beata ; Smedmyr, Bengt ; Astrom, Maria ; Amini, Rose-Marie ; Hallbook, Helene. / Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study. In: Medical Oncology. 2015 ; Vol. 32, No. 4. pp. 135.

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TY - JOUR

T1 - Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study

AU - Bergfelt, Emma

AU - Kozlowski, Piotr

AU - Ahlberg, Lucia

AU - Hulegardh, Erik

AU - Hagglund, Hans

AU - Karlsson, Karin

AU - Markuszewska-Kuczymska, Alicja

AU - Tomaszewska-Toporska, Beata

AU - Smedmyr, Bengt

AU - Astrom, Maria

AU - Amini, Rose-Marie

AU - Hallbook, Helene

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematology/Transplantation (013022014)

PY - 2015

Y1 - 2015

N2 - The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status >= 2. MRD < 0.1 % after induction had positive impact on continuous complete remission but not on OS. Only five patients were allocated to allogeneic haematopoietic stem cell transplantation in first remission, mainly due to conventional high risk factors. Thus, use of intensive remission induction therapy is effective in a selection of older patients. In a population for whom the possibilities of treatment escalation are limited, the optimal role of MRD monitoring remains to be determined.

AB - The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status >= 2. MRD < 0.1 % after induction had positive impact on continuous complete remission but not on OS. Only five patients were allocated to allogeneic haematopoietic stem cell transplantation in first remission, mainly due to conventional high risk factors. Thus, use of intensive remission induction therapy is effective in a selection of older patients. In a population for whom the possibilities of treatment escalation are limited, the optimal role of MRD monitoring remains to be determined.

KW - Acute lymphoblastic leukaemia

KW - Adults

KW - Minimal residual disease

KW - Flow

KW - cytometry

U2 - 10.1007/s12032-015-0582-2

DO - 10.1007/s12032-015-0582-2

M3 - Article

VL - 32

SP - 135

JO - Medical Oncology and Tumor Pharmacotherapy

JF - Medical Oncology and Tumor Pharmacotherapy

SN - 0736-0118

IS - 4

ER -