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Impact of early NGS MRD negativity on outcomes in B-cell ALL: A retrospective analysis
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Although MRD negativity is an important clinical endpoint in ALL, it is unclear whether NGS MRD negativity can improve the prognosis in patients with high-risk ALL. During the 66th ASH Annual Meeting and Exposition, Walid Macaron presented results from a retrospective analysis assessing the impact of NGS MRD negativity (1 x 10-6) on outcomes in patients with newly diagnosed B-cell ALL (N = 161).1 |
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Compared with NGS MRD positivity, MRD negativity was associated with higher 2-year RFS at 1.5 months (94% vs 66%; p = 0.03), 3 months (82% vs 65%; p = 0.08), and 6 months (82% vs 62%; p = 0.01). |
| The 2-year RFS was higher in patients with Ph- B-cell ALL who were MRD negative at 1.5 months (100% vs 69%; p = 0.03), 3 months (83% vs 60%; p = 0.04), and 6 months (87% vs 50%; p < 0.001) compared with those who were MRD positive. |
| Among MRD-positive patients, 2-year RFS was higher at 1.5 months (80% vs 0%; p = 0.009) and 3 months (86% vs 21%; p = 0.02) in those who received allo-HSCT vs those who did not. |
| These findings show that early achievement of NGS MRD negativity is associated with favorable outcomes in patients with high-risk B-cell ALL, and that NGS-based MRD assessment should be incorporated into risk stratification and treatment protocols. |
Abbreviations: ALL, acute lymphoblastic leukemia; allo-HSCT, allogeneic hematopoietic stem cell transplantation; ASH, American Society of Hematology; MRD, measurable residual disease; NGS, next-generation sequencing; Ph-, Philadelphia chromosome-negative; RFS, relapse-free survival.
- Macaron W. Early achievement of deep measurable residual disease (MRD) negativity identifies patients with B-Cell acute lymphoblastic leukemia (ALL) who have excellent long-term outcomes and do not benefit from allogeneic stem cell transplant, irrespective of baseline high-risk cytomolecular features. Oral abstract #727. 66th ASH Annual Meeting and Exposition; Dec 7–10, 2024; San Diego, US.
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