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Blood, 1 February 2006, Vol. 107, No. 3, pp. 1116-1123. Prepublished online as a Blood First Edition Paper on September 29, 2005; DOI 10.1182/blood-2005-07-2708. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-07-2708v1 107/3/1116    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Brüggemann, M. Articles by Kneba, M. Search for Related Content PubMed PubMed Citation Articles by Brüggemann, M. Articles by Kneba, M. Related Collections Neoplasia Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  NEOPLASIA Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemia Monika Brüggemann, Thorsten Raff, Thomas Flohr, Nicola Gökbuget, Makoto Nakao, Jo Droese, Silke Lüschen, Christiane Pott, Matthias Ritgen, Urban Scheuring, Heinz-August Horst, Eckhard Thiel, Dieter Hoelzer, Claus R. Bartram, Michael Kneba, for the German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia From the Medical Clinic II, University of Kiel, Germany; Institute of Human Genetics, University of Heidelberg, Germany; Medical Clinic II, Department of Hematology, University of Frankfurt, Germany; and Medical Clinic III, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany. Adult patients with acute lymphoblastic leukemia (ALL) who are stratified into the standard-risk (SR) group due to the absence of adverse prognostic factors relapse in 40% to 55% of the cases. To identify complementary markers suitable for further treatment stratification in SR ALL, we evaluated the predictive value of minimal residual disease (MRD) and prospectively monitored MRD in 196 strictly defined SR ALL patients at up to 9 time points in the first year of treatment by quantitative polymerase chain reaction (PCR). Frequency of MRD positivity decreased from 88% during early induction to 13% at week 52. MRD was predictive for relapse at various follow-up time points. Combined MRD information from different time points allowed definition of 3 risk groups (P < .001): 10% of patients with a rapid MRD decline to lower than 10-4 or below detection limit at day 11 and day 24 were classified as low risk and had a 3-year relapse rate (RR) of 0%. A subset of 23% with an MRD of 10-4 or higher until week 16 formed the high-risk group, with a 3-year RR of 94% (95% confidence interval [CI] 83%-100%). The remaining patients whose RR was 47% (31%-63%) represented the intermediate-risk group. Thus, MRD quantification during treatment identified prognostic subgroups within the otherwise homogeneous SR ALL population who may benefit from individualized treatment. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: In adult ALL, less is now more Mark A Weiss and Nicole Lamanna Blood 2006 107: 852-853. [Full Text] [PDF] This article has been cited by other articles: D. I. Marks, W. S. Perez, W. He, M.-J. Zhang, M. R. Bishop, B. J. Bolwell, C. N. Bredeson, E. A. Copelan, R. P. Gale, V. Gupta, et al. Unrelated donor transplants in adults with Philadelphia-negative acute lymphoblastic leukemia in first complete remission Blood, July 15, 2008; 112(2): 426 - 434. 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In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993) Blood, February 15, 2008; 111(4): 1827 - 1833. [Abstract] [Full Text] [PDF] J. M. Rowe and A. H. Goldstone How I treat acute lymphocytic leukemia in adults Blood, October 1, 2007; 110(7): 2268 - 2275. [Abstract] [Full Text] [PDF] C. D. Baldus, P. Martus, T. Burmeister, S. Schwartz, N. Gokbuget, C. D. Bloomfield, D. Hoelzer, E. Thiel, and W. K. Hofmann Low ERG and BAALC Expression Identifies a New Subgroup of Adult Acute T-Lymphoblastic Leukemia With a Highly Favorable Outcome J. Clin. Oncol., August 20, 2007; 25(24): 3739 - 3745. [Abstract] [Full Text] [PDF] S. Agrawal, M. Unterberg, S. Koschmieder, U. zur Stadt, U. 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