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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 (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 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 Bruggemann, M. Articles by Kneba, M. Search for Related Content PubMed PubMed Citation Articles by Bruggemann, M. Articles by Kneba, M. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 8, 2005 Accepted September 18, 2005 Clinical significance of minimal residual disease quantification in adult patients with standard risk acute lymphoblastic leukemia Monika Bruggemann*, Thorsten Raff, Thomas Flohr, Nicola Gokbuget, Makoto Nakao, Jo Droese, Silke Luschen, Christiane Pott, Matthias Ritgen, Urban Scheuring, Heinz-August Horst, Eckhard Thiel, Dieter Hoelzer, Claus R Bartram, and Michael Kneba Medical Clinic II, University of Kiel, Kiel, Germany Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany Medical Clinic II, Department of Hematology, University of Frankfurt, Frankfurt, Germany Medical Clinic III, Charite Universitatsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany * Corresponding author; email: m.brueggemann{at}med2.uni-kiel.de. 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 40-55% 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 nine time-points during the first year of treatment by quantitative 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 three risk groups (p< 0.001): 10% of patients with a rapid MRD decline to < 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 MRD10-4 until week+16 formed the high-risk group with a 3-year RR of 94% (95% 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: C. D. Baldus, J. Thibaut, N. Goekbuget, A. Stroux, C. Schlee, M. Mossner, T. Burmeister, S. Schwartz, C. D. Bloomfield, D. Hoelzer, et al. Prognostic implications of NOTCH1 and FBXW7 mutations in adult acute T-lymphoblastic leukemia Haematologica, October 1, 2009; 94(10): 1383 - 1390. [Abstract] [Full Text] [PDF] M. R. Mansour, M. L. Sulis, V. Duke, L. 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