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Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies

Achieving undetectable MRD (U-MRD) status after chemoimmunotherapy predicts longer progression-free and overall survival. The predictive factors and timing of relapse in patients with U-MRD and value of interim MRD analysis are ill-defined. This was a prospective study of 289 patients with CLL treat...

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Autores principales: Thompson, Philip A., Peterson, Christine B., Strati, Paolo, Jorgensen, Jeff, Keating, Michael J., O’Brien, Susan M., Ferrajoli, Alessandra, Burger, Jan A., Estrov, Zeev, Jain, Nitin, Kadia, Tapan M., Borthakur, Gautam, DiNardo, Courtney D., Daver, Naval, Jabbour, Elias, Wierda, William G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192870/
https://www.ncbi.nlm.nih.gov/pubmed/29769624
http://dx.doi.org/10.1038/s41375-018-0132-y
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author Thompson, Philip A.
Peterson, Christine B.
Strati, Paolo
Jorgensen, Jeff
Keating, Michael J.
O’Brien, Susan M.
Ferrajoli, Alessandra
Burger, Jan A.
Estrov, Zeev
Jain, Nitin
Kadia, Tapan M.
Borthakur, Gautam
DiNardo, Courtney D.
Daver, Naval
Jabbour, Elias
Wierda, William G.
author_facet Thompson, Philip A.
Peterson, Christine B.
Strati, Paolo
Jorgensen, Jeff
Keating, Michael J.
O’Brien, Susan M.
Ferrajoli, Alessandra
Burger, Jan A.
Estrov, Zeev
Jain, Nitin
Kadia, Tapan M.
Borthakur, Gautam
DiNardo, Courtney D.
Daver, Naval
Jabbour, Elias
Wierda, William G.
author_sort Thompson, Philip A.
collection PubMed
description Achieving undetectable MRD (U-MRD) status after chemoimmunotherapy predicts longer progression-free and overall survival. The predictive factors and timing of relapse in patients with U-MRD and value of interim MRD analysis are ill-defined. This was a prospective study of 289 patients with CLL treated first-line with FCR. MRD analysis was performed after course 3 (C3) and at end-of-therapy (EOT) in bone marrow using 4-color flow cytometry (sensitivity 10(−4)). Eighteen percent of patients had U-MRD after C3 and 48% at EOT. U-MRD status at EOT was associated with longer PFS (median NR vs 38mo, p<0.001). MRD level (≤1% vs. >1%) after C3 predicted greater likelihood of U-MRD status at EOT (64% vs. 9%, p<0.001). PFS was significantly longer for patients with MRD ≤1% vs. >1% after C3 (median 73mo vs 41mo, p<0.001), but similar for <0.01% vs. 0.01–1%. Interim MRD status may therefore be used for risk stratification and to individualize therapy. Eighty-five patients with U-MRD status at EOT had yearly blood MRD monitoring; MRD re-emerged in 38/85, a median of 48mo after EOT and preceded clinical progression by a median of 24 months, which may allow development of early intervention strategies.
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spelling pubmed-61928702018-10-18 Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies Thompson, Philip A. Peterson, Christine B. Strati, Paolo Jorgensen, Jeff Keating, Michael J. O’Brien, Susan M. Ferrajoli, Alessandra Burger, Jan A. Estrov, Zeev Jain, Nitin Kadia, Tapan M. Borthakur, Gautam DiNardo, Courtney D. Daver, Naval Jabbour, Elias Wierda, William G. Leukemia Article Achieving undetectable MRD (U-MRD) status after chemoimmunotherapy predicts longer progression-free and overall survival. The predictive factors and timing of relapse in patients with U-MRD and value of interim MRD analysis are ill-defined. This was a prospective study of 289 patients with CLL treated first-line with FCR. MRD analysis was performed after course 3 (C3) and at end-of-therapy (EOT) in bone marrow using 4-color flow cytometry (sensitivity 10(−4)). Eighteen percent of patients had U-MRD after C3 and 48% at EOT. U-MRD status at EOT was associated with longer PFS (median NR vs 38mo, p<0.001). MRD level (≤1% vs. >1%) after C3 predicted greater likelihood of U-MRD status at EOT (64% vs. 9%, p<0.001). PFS was significantly longer for patients with MRD ≤1% vs. >1% after C3 (median 73mo vs 41mo, p<0.001), but similar for <0.01% vs. 0.01–1%. Interim MRD status may therefore be used for risk stratification and to individualize therapy. Eighty-five patients with U-MRD status at EOT had yearly blood MRD monitoring; MRD re-emerged in 38/85, a median of 48mo after EOT and preceded clinical progression by a median of 24 months, which may allow development of early intervention strategies. 2018-04-17 2018-11 /pmc/articles/PMC6192870/ /pubmed/29769624 http://dx.doi.org/10.1038/s41375-018-0132-y Text en Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms
spellingShingle Article
Thompson, Philip A.
Peterson, Christine B.
Strati, Paolo
Jorgensen, Jeff
Keating, Michael J.
O’Brien, Susan M.
Ferrajoli, Alessandra
Burger, Jan A.
Estrov, Zeev
Jain, Nitin
Kadia, Tapan M.
Borthakur, Gautam
DiNardo, Courtney D.
Daver, Naval
Jabbour, Elias
Wierda, William G.
Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies
title Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies
title_full Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies
title_fullStr Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies
title_full_unstemmed Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies
title_short Serial minimal residual disease (MRD) monitoring during first-line FCR treatment for CLL may direct individualized therapeutic strategies
title_sort serial minimal residual disease (mrd) monitoring during first-line fcr treatment for cll may direct individualized therapeutic strategies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192870/
https://www.ncbi.nlm.nih.gov/pubmed/29769624
http://dx.doi.org/10.1038/s41375-018-0132-y
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