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  • Ifversen, MarianneCopenhagen Univ Hosp, Rigshosp, Dept Paediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark (author)

Low burden of minimal residual disease prior to transplantation in children with very high risk acute lymphoblastic leukaemia : The NOPHO ALL2008 experience

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • 2019-01-24
  • Wiley,2019
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-379930
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-379930URI
  • https://doi.org/10.1111/bjh.15761DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:140473403URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • The population-based Nordic/Baltic acute lymphoblastic leukaemia (ALL) Nordic Society for Paediatric Haematology and Oncology (NOPHO) ALL2008 protocol combined minimal residual disease (MRD)-driven treatment stratification with very intense first line chemotherapy for patients with high risk ALL. Patients with MRD >= 5% at end of induction or >= 10(-3) at end of consolidation or following two high risk blocks were eligible for haematopoietic cell transplantation (HCT) in first remission. After at least three high risk blocks a total of 71 children received HCT, of which 46 had MRD >= 5% at end of induction. Ten patients stratified to HCT were not transplanted; 12 received HCT without protocol indication. Among 69 patients with evaluable pre-HCT MRD results, 22 were MRD-positive, one with MRD >= 10(-3). After a median follow-up of 5 center dot 5 years, the cumulative incidence of relapse was 23 center dot 5% (95% confidence interval [CI]: 10 center dot 5-47 center dot 7) for MRD-positive versus 5 center dot 1% (95% CI: 1 center dot 3-19 center dot 2), P = 0 center dot 02) for MRD-negative patients. MRD was the only variable significantly associated with relapse (hazard ratio 9 center dot 1, 95% CI: 1 center dot 6-51 center dot 0, P = 0 center dot 012). Non-relapse mortality did not differ between the two groups, resulting in disease-free survival of 85 center dot 6% (95% CI: 75 center dot 4-97 center dot 2) and 67 center dot 4% (95% CI: 50 center dot 2-90 center dot 5), respectively. In conclusion, NOPHO block treatment efficiently reduced residual leukaemia which, combined with modern transplant procedures, provided high survival rates, also among pre-HCT MRD-positive patients.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Turkiewicz, DominikLund Univ, Lund, Sweden (author)
  • Marquart, Hanne V.Rigshosp, Copenhagen Univ Hosp, Dept Clin Immunol, Tissue Typing Lab, Copenhagen, Denmark (author)
  • Winiarski, JacekKarolinska Institutet (author)
  • Buechner, JochenOslo Univ Hosp, Dept Paediat Haematol & Oncol, Oslo, Norway (author)
  • Mellgren, KarinQueen Silvia Childrens Hosp, Dept Paediat, Inst Clin Sci, Gothenburg, Sweden (author)
  • Arvidson, Johan,1953-Uppsala universitet,Barnneurologi/Barnonkologi(Swepub:uu)johanas (author)
  • Rascon, JelenaVilnius Univ Hosp, Childrens Hosp, Ctr Paediat Oncol & Haematol, Vilnius, Lithuania (author)
  • Korgvee, Lenne-TriinTallin Childrens Hosp, Tallinn, Estonia (author)
  • Madsen, Hans O.Rigshosp, Copenhagen Univ Hosp, Dept Clin Immunol, Tissue Typing Lab, Copenhagen, Denmark (author)
  • Abrahamsson, JonasQueen Silvia Childrens Hosp, Dept Paediat, Inst Clin Sci, Gothenburg, Sweden (author)
  • Lund, BendikSt Olavs Univ Hosp Trondheim, Dept Paediat, Trondheim, Norway;NTNU, Dept Clin & Mol Med, Trondheim, Norway (author)
  • Jonsson, Olafur G.Landspitali Univ Hosp, Reykjavik, Iceland (author)
  • Heilmann, CarstenCopenhagen Univ Hosp, Rigshosp, Dept Paediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark (author)
  • Heyman, MatsKarolinska Institutet (author)
  • Schmiegelow, KjeldCopenhagen Univ Hosp, Rigshosp, Dept Paediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark;Univ Copenhagen, Inst Clin Med, Copenhagen, Denmark (author)
  • Vettenranta, KimUniv Helsinki, Dept Paediat, Helsinki, Finland (author)
  • Copenhagen Univ Hosp, Rigshosp, Dept Paediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, DenmarkLund Univ, Lund, Sweden (creator_code:org_t)

Related titles

  • In:British Journal of Haematology: Wiley184:6, s. 982-9930007-10481365-2141

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