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Blood, 1 February 2007, Vol. 109, No. 3, pp. 910-915. Prepublished online as a Blood First Edition Paper on October 5, 2006; DOI 10.1182/blood-2006-07-037093. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-07-037093v1 109/3/910    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 Raff, T. Articles by Brüggemann, M. Search for Related Content PubMed PubMed Citation Articles by Raff, T. Articles by Brüggemann, M. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Molecular relapse in adult standard-risk ALL patients detected by prospective MRD monitoring during and after maintenance treatment: data from the GMALL 06/99 and 07/03 trials Thorsten Raff1, Nicola Gökbuget2, Silke Lüschen1, Regina Reutzel2, Matthias Ritgen1, Sebastian Irmer1, Sebastian Böttcher1, Heinz-August Horst1, Michael Kneba1, Dieter Hoelzer2, Monika Brüggemann1, for the GMALL Study Group 1 Second Medical Department, Division of Hematology and Oncology, University Schleswig-Holstein, Campus Kiel, Germany; and 2 Third Medical Department, Division of Hematology and Oncology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany Although levels of minimal residual disease (MRD) decrease below the detection limit in most adult patients with standard-risk acute lymphoblastic leukemia (ALL) after consolidation treatment, about 30% of these patients will ultimately relapse. To evaluate the power of MRD monitoring as an indicator of impending relapse, we prospectively analyzed postconsolidation samples of 105 patients enrolled in the German Multicenter ALL (GMALL) trial by real-time quantitative polymerase chain reaction (PCR) of clonal immune gene rearrangements. All patients were in hematologic remission, had completed first-year polychemotherapy, and tested MRD negative prior to study entry. Twenty-eight of 105 patients (27%) converted to MRD positivity thereafter, and 17 of 28 (61%) relapsed so far. Median time from molecular (MRD-positive) to clinical relapse was 9.5 months. In 15 of these patients, MRD within the quantitative range of PCR was measured in hematologic remission, and 13 of these patients (89%) relapsed after a median interval of 4.1 months. Of the 77 continuously MRD-negative patients, only 5 (6%) have relapsed. We conclude that conversion to MRD positivity during the early postconsolidation phase in adult standard-risk ALL patients is highly predictive of subsequent hematologic relapse. As a result of the study, as of spring 2006, salvage treatment in the ongoing GMALL trial is intended to be started at the time of recurrence of quantifiable MRD. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. R. Mansour, M. L. Sulis, V. Duke, L. Foroni, S. Jenkinson, K. Koo, C. G. Allen, R. E. Gale, G. Buck, S. Richards, et al. Prognostic Implications of NOTCH1 and FBXW7 Mutations in Adults With T-Cell Acute Lymphoblastic Leukemia Treated on the MRC UKALLXII/ECOG E2993 Protocol J. Clin. Oncol., September 10, 2009; 27(26): 4352 - 4356. [Abstract] [Full Text] [PDF] C. A. Scrideli, J. G. Assumpcao, M. A. Ganazza, M. Araujo, S. R. Toledo, M. L. M. Lee, E. Delbuono, A. S. Petrilli, R. P. Queiroz, A. Biondi, et al. A simplified minimal residual disease polymerase chain reaction method at early treatment points can stratify children with acute lymphoblastic leukemia into good and poor outcome groups Haematologica, June 1, 2009; 94(6): 781 - 789. [Abstract] [Full Text] [PDF] J. J. Cornelissen, B. van der Holt, G. E. G. Verhoef, M. B. van 't Veer, M. H. J. van Oers, H. C. Schouten, G. Ossenkoppele, P. Sonneveld, J. Maertens, M. van Marwijk Kooy, et al. Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison Blood, February 5, 2009; 113(6): 1375 - 1382. [Abstract] [Full Text] [PDF] L. Fischer, N. Gokbuget, S. Schwartz, T. Burmeister, H. Rieder, M. Bruggemann, D. Hoelzer, and E. Thiel CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy Haematologica, February 1, 2009; 94(2): 224 - 229. [Abstract] [Full Text] [PDF] A. Bagg Malleable Immunoglobulin Genes and Hematopathology - The Good, the Bad, and the Ugly: A Paper from the 2007 William Beaumont Hospital Symposium on Molecular Pathology J. Mol. Diagn., September 1, 2008; 10(5): 396 - 410. [Abstract] [Full Text] [PDF] M. J. Borowitz, M. Devidas, S. P. Hunger, W. P. Bowman, A. J. Carroll, W. L. Carroll, S. Linda, P. L. Martin, D. J. Pullen, D. Viswanatha, et al. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study Blood, June 15, 2008; 111(12): 5477 - 5485. [Abstract] [Full Text] [PDF] J.-M. Ribera, A. Oriol, M.-A. Sanz, M. Tormo, P. Fernandez-Abellan, E. del Potro, E. Abella, J. Bueno, R. Parody, P. Bastida, et al. Comparison of the Results of the Treatment of Adolescents and Young Adults With Standard-Risk Acute Lymphoblastic Leukemia With the Programa Espanol de Tratamiento en Hematologia Pediatric-Based Protocol ALL-96 J. Clin. Oncol., April 10, 2008; 26(11): 1843 - 1849. [Abstract] [Full Text] [PDF] A. H. Goldstone, S. M. Richards, H. M. Lazarus, M. S. Tallman, G. Buck, A. K. Fielding, A. K. Burnett, R. Chopra, P. H. Wiernik, L. Foroni, et al. 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] D. Campana Molecular Determinants of Treatment Response in Acute Lymphoblastic Leukemia Hematology, January 1, 2008; 2008(1): 366 - 373. [Abstract] [Full Text] [PDF] A. Fielding The Treatment of Adults with Acute Lymphoblastic Leukemia Hematology, January 1, 2008; 2008(1): 381 - 389. [Abstract] [Full Text] [PDF]

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