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Low burden of minim...
Low burden of minimal residual disease prior to transplantation in children with very high risk acute lymphoblastic leukaemia : The NOPHO ALL2008 experience
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- Ifversen, Marianne (author)
- Copenhagen Univ Hosp, Rigshosp, Dept Paediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
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- Turkiewicz, Dominik (author)
- Lund Univ, Lund, Sweden
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- Marquart, Hanne V. (author)
- Rigshosp, Copenhagen Univ Hosp, Dept Clin Immunol, Tissue Typing Lab, Copenhagen, Denmark
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- Winiarski, Jacek (author)
- Karolinska Institutet
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- Buechner, Jochen (author)
- Oslo Univ Hosp, Dept Paediat Haematol & Oncol, Oslo, Norway
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- Mellgren, Karin (author)
- Queen Silvia Childrens Hosp, Dept Paediat, Inst Clin Sci, Gothenburg, Sweden
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- Arvidson, Johan, 1953- (author)
- Uppsala universitet,Barnneurologi/Barnonkologi
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- Rascon, Jelena (author)
- Vilnius Univ Hosp, Childrens Hosp, Ctr Paediat Oncol & Haematol, Vilnius, Lithuania
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- Korgvee, Lenne-Triin (author)
- Tallin Childrens Hosp, Tallinn, Estonia
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- Madsen, Hans O. (author)
- Rigshosp, Copenhagen Univ Hosp, Dept Clin Immunol, Tissue Typing Lab, Copenhagen, Denmark
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- Abrahamsson, Jonas (author)
- Queen Silvia Childrens Hosp, Dept Paediat, Inst Clin Sci, Gothenburg, Sweden
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- Lund, Bendik (author)
- St Olavs Univ Hosp Trondheim, Dept Paediat, Trondheim, Norway;NTNU, Dept Clin & Mol Med, Trondheim, Norway
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- Jonsson, Olafur G. (author)
- Landspitali Univ Hosp, Reykjavik, Iceland
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- Heilmann, Carsten (author)
- Copenhagen Univ Hosp, Rigshosp, Dept Paediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
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- Heyman, Mats (author)
- Karolinska Institutet
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- Schmiegelow, Kjeld (author)
- Copenhagen Univ Hosp, Rigshosp, Dept Paediat & Adolescent Med, Blegdamsvej 9, DK-2100 Copenhagen, Denmark;Univ Copenhagen, Inst Clin Med, Copenhagen, Denmark
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- Vettenranta, Kim (author)
- Univ Helsinki, Dept Paediat, Helsinki, Finland
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(creator_code:org_t)
- 2019-01-24
- 2019
- English.
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In: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 184:6, s. 982-993
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- acute lymphoblastic leukaemia
- haematopoietic stem cell transplantation
- minimal residual disease
- children
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ifversen, Marian ...
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Turkiewicz, Domi ...
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Marquart, Hanne ...
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Winiarski, Jacek
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Buechner, Jochen
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Mellgren, Karin
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Arvidson, Johan, ...
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Rascon, Jelena
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Korgvee, Lenne-T ...
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Madsen, Hans O.
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Abrahamsson, Jon ...
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Lund, Bendik
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Jonsson, Olafur ...
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Heilmann, Carste ...
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Heyman, Mats
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Schmiegelow, Kje ...
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Vettenranta, Kim
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MEDICAL AND HEAL ...
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British Journal ...
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Uppsala University
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Karolinska Institutet