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2024-11-26T16:09:31.000Z

Impact of maintaining MRD negativity post-induction on survival outcomes in patients with B-ALL

Nov 26, 2024
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Learning objective: After reading this article, learners will be able to cite a new clinical development in acute lymphoblastic leukemia.

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A single-center retrospective analysis assessed the impact of dynamic MRD assessment on survival prediction in 65 patients with B-ALL.1 MRD was assessed after induction, consolidation, and every 3 months up to 3 years.1 Results from this analysis were published in Hematology by Chen et al.1

Key learnings
Maintaining MRD− status post-induction was associated with improved median PFS (not reached vs 11.3 months; HR, 0.26; 95% CI, 0.13–0.51; p < 0.0001) vs not maintaining MRD– status.  
Allo-HSCT improved median PFS (14.5 months vs 6.5 months; HR, 0.23; 95% CI, 0.07–0.82; p = 0.0039) and OS (not reached vs 17.8 months; HR, 0.25; 95% CI, 0.07–0.91; p = 0.0237) vs no allo-HSCT in patients unable to maintain MRD negativity. 
Among high-risk patients (n = 46), maintaining MRD negativity was associated with improved median PFS (not reached vs 11.3 months; HR, 0.28; 95% CI, 0.09–0.48; p = 0.0016) vs patients who did not maintain MRD negativity.  
Results from this analysis suggest that dynamic MRD assessment in patients with ALL, can be used to help predict survival outcomes, guide patient selection for allo-HSCT, and further risk stratify high-risk patients.  

Abbreviations: allo-HSCT, allogeneic hematopoietic stem cell transplantation; B-ALL, B-cell acute lymphoblastic leukemia; CI, confidence interval; HR, hazard ratio; MRD, measurable residual disease; OS, overall survival; PFS, progression-free survival.  

  1. Chen Y, Liu, R, Li J. The significance of MRD-based strategy by dynamic assessment to guide treatment decisions in B-ALL - the enlightenment provided by demonstrating survival differences in the retrospective study. 2024;29(1):2415589. DOI: 10.1080/16078454.2024.2415589

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