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Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study
Uppsala University, Sweden.
University of Örebro, Sweden.
Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences.
Sahlgrens University Hospital, Sweden.
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2015 (English)In: Medical Oncology, ISSN 1357-0560, E-ISSN 1559-131X, Vol. 32, no 4, 135- p.Article in journal (Refereed) Published
Abstract [en]

The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status greater than= 2. MRD less than 0.1 % after induction had positive impact on continuous complete remission but not on OS. Only five patients were allocated to allogeneic haematopoietic stem cell transplantation in first remission, mainly due to conventional high risk factors. Thus, use of intensive remission induction therapy is effective in a selection of older patients. In a population for whom the possibilities of treatment escalation are limited, the optimal role of MRD monitoring remains to be determined.

Place, publisher, year, edition, pages
Humana Press , 2015. Vol. 32, no 4, 135- p.
Keyword [en]
Acute lymphoblastic leukaemia; Adults; Minimal residual disease; Flow cytometry
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-117222DOI: 10.1007/s12032-015-0582-2ISI: 000351474100049PubMedID: 25796502OAI: diva2:807112

Funding Agencies|Lions Cancer Research Foundation, Uppsala

Available from: 2015-04-22 Created: 2015-04-21 Last updated: 2016-03-24

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Ahlberg, Lucia
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Department of HaematologyFaculty of Medicine and Health SciencesDivision of Clinical Sciences
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