Page 140 - 2019_10 resto del Mondo_web

R. Bassan et al.
comes.57 In another study assessing patients with Ph-neg- ative B-ALL or T-ALL, an early MRD response (day 11) was associated with the best prognosis.58 In addition, in an analysis of patients with Ph-negative ALL from France, Belgium and Switzerland, lack of MRD response 6 weeks after induction initiation could identify patients who would benefit most from HSCT.59 This highlights the
importance of early testing if MRD status is to be used to influence treatment decisions.
Information from MRD testing could help to target highly effective immunotherapies, as well as therapies that are less well tolerated, such as HSCT, to those at high risk of relapse. In a study of Ph-negative patients from the GRAALL-2003 or -2005 trials, transplant was found to
Figure 5. Forest plot of overall survival hazard ratios by subgroup (random effects model). B cell ALL/B-ALL: B-cell acute lymphoblastic leukemia; CI: confidence interval; CR1: first complete remission; CR2: second complete remission; chemo: chemotherapy; Flow: flow cytometry; HR: hazard ratio; HSCT: hematopoietic stem- cell transplantation; MRD: minimal residual disease; MRD neg: minimal residual disease-negative status; MRD pos: minimal residual disease-positive status; N: number of studies; PCR: polymerase chain reaction; Ph: Philadelphia chromosome; SCT: stem-cell transplantation; targeted: targeted agent (e.g., tyrosine kinase inhibitor, blinatumomab, inotuzumab); tx: treatment.
2036
haematologica | 2019; 104(10)