Details

Autor(en) / Beteiligte

• Stutterheim, J.
• de Lorenzo, P.
• van der Sluis, I.M.
• Alten, J.
• Ancliffe, P.
• Attarbaschi, A.
• Aversa, L.
• Boer, J.M.
• Biondi, A.
• Brethon, B.
• Diaz, P.
• Cazzaniga, G.
• Escherich, G.
• Ferster, A.
• Kotecha, R.S.
• Lausen, B.
• Leung, Alex WK
• Locatelli, F.
• Silverman, L.
• Stary, J.
• Szczepanski, T.
• van der Velden, V.H.J.
• Vora, A.
• Zuna, J.
• Schrappe, M.
• Valsecchi, M.G.
• Pieters, R.

Titel

Minimal residual disease and outcome characteristics in infant KMT2A-germline acute lymphoblastic leukaemia treated on the Interfant-06 protocol

Ist Teil von

• European journal of cancer (1990), 2022-01, Vol.160, p.72-79

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2022

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• The outcome of infants with KMT2A-germline acute lymphoblastic leukaemia (ALL) is superior to that of infants with KMT2A-rearranged ALL but has been inferior to non-infant ALL patients. Here, we describe the outcome and prognostic factors for 167 infants with KMT2A-germline ALL enrolled in the Interfant-06 study. Univariate analysis on prognostic factors (age, white blood cell count at diagnosis, prednisolone response and CD10 expression) was performed on KMT2A-germline infants in complete remission at the end of induction (EOI; n = 163). Bone marrow minimal residual disease (MRD) was measured in 73 patients by real-time quantitative polymerase chain reaction at various time points (EOI, n = 68; end of consolidation, n = 56; and before OCTADAD, n = 57). MRD results were classified as negative, intermediate (<5∗10−4), and high (≥5∗10−4). The 6-year event-free and overall survival was 73.9% (standard error [SE] = 3.6) and 87.2% (SE = 2.7). Relapses occurred early, within 36 months from diagnosis in 28 of 31 (90%) infants. Treatment-related mortality was 3.6%. Age <6 months was a favourable prognostic factor with a 6-year disease-free survival (DFS) of 91% (SE = 9.0) compared with 71.7% (SE = 4.2) in infants >6 months of age (P = 0.04). Patients with high EOI MRD ≥5 × 10−4 had a worse outcome (6-year DFS 61.4% [SE = 12.4], n = 16), compared with patients with undetectable EOI MRD (6-year DFS 87.9% [SE = 6.6], n = 28) or intermediate EOI MRD <5 × 10−4 (6-year DFS 76.4% [SE = 11.3], n = 24; P = 0.02). We conclude that young age at diagnosis and low EOI MRD seem favourable prognostic factors in infants with KMT2A-germline ALL and should be considered for risk stratification in future clinical trials. •Prognostic factors for infants with KMT2A-germline acute lymphoblastic leukaemia (ALL) are not well known.•Characteristics of 167 uniformly treated infants with KMt2A-germline ALL were analyzed.•Young age at diagnosis (<6 months) was associated with better outcome.•End of induction minimal residual disease (MRD), rather than end of consolidation MRD, was a prognostic factor for outcome.•Combined MRD and genetic-based stratification of KMT2A-g infants should be considered.