• Blood · Feb 2000

    Comparative Study

    Rapid molecular response during early induction chemotherapy predicts a good outcome in childhood acute lymphoblastic leukemia.

    • E R Panzer-Grümayer, M Schneider, S Panzer, K Fasching, and H Gadner.
    • Children's Cancer Research Institute and St. Anna Kinderspital, Vienna, Austria. panzer@ccri.univie.ac.at
    • Blood. 2000 Feb 1; 95 (3): 790-4.

    AbstractEarly response to therapy is an independent prognostic factor in childhood acute lymphoblastic leukemia. Although most patients have rapid early responses, as detected by morphology, 15% to 20% of patients have relapses. The authors evaluated residual disease by molecular methods on day 15 of minimal residual disease (MRD) therapy and compared these data with their recently established MRD-based risk stratification, defined by MRD levels 5 weeks after induction treatment and before consolidation. All 68 children treated according to current Berlin-Frankfurt-Münster (BFM) protocols went into morphologically complete remission after induction. There was a significant difference in outcome between children with rapid disease clearance and those with high levels of day-15 MRD (P =.035). Among patients with high levels of day-15 MRD, only the MRD-based risk stratification was predictive of the outcome. All patients with negative or low day-15 MRD had excellent prognoses and were in the MRD-based low-risk group. Thus, after only 2 weeks of treatment, the authors were able to identify a patient population of 20% who may benefit from the least intensive treatment.

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