The prognostic impact of minimal residual disease in patients with chronic lymphocytic leukemia requiring first-line therapy.

A proportion of patients with chronic lymphocytic leukemia achieve a minimal residual disease negative status after therapy. We retrospectively evaluated the impact of minimal residual disease on the outcome of 255 consecutive patients receiving any front-line therapy in the context of a detailed pr...

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Detalles Bibliográficos
Autores: Santacruz, Rodrigo, Villamor i Casas, Neus, Aymerich Gregorio, Marta, Martínez Trillos, Alejandra, López González, Cristina, Navarro López, Alba, Rozman, María, Beà Bobet, Sílvia M., Royo Moreno, Cristina, Cazorla, Maite, Colomer Pujol, Dolors, Giné Soca, Eva, Pinyol, Magda, Puente, Xose S., López-Otin, Carlos, Campo Güerri, Elias, López Guillermo, Armando, Delgado, Julio (Delgado González)
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/121168
Acceso en línea:https://hdl.handle.net/2445/121168
Access Level:acceso abierto
Palabra clave:Leucèmia limfocítica crònica
Biologia molecular
Limfomes
Chronic lymphocytic leukemia
Molecular biology
Lymphomas
Descripción
Sumario:A proportion of patients with chronic lymphocytic leukemia achieve a minimal residual disease negative status after therapy. We retrospectively evaluated the impact of minimal residual disease on the outcome of 255 consecutive patients receiving any front-line therapy in the context of a detailed prognostic evaluation, including assessment of IGHV, TP53, NOTCH1 and SF3B1 mutations. The median follow-up was 73 months (range, 2-202) from disease evaluation. The median treatment-free survival durations for patients achieving a complete response without or with minimal residual disease, a partial response and no response were 76, 40, 11 and 11 months, respectively (P<0.001). Multivariate analysis revealed that three variables had a significant impact on treatment-free survival: minimal residual disease (P<0.001), IGHV status (P<0.001) and β2-microglobulin levels (P=0.012). With regards to overall survival, factors predictive of an unfavorable outcome were minimal residual disease positivity (P=0.014), together with advanced age (P<0.001), unmutated IGHV status (P=0.001), TP53 mutations (P<0.001) and elevated levels of β2-microglobulin (P=0.003). In conclusion, for patients requiring front-line therapy, achievement of minimal residual disease negativity is associated with significantly prolonged treatment-free and overall survival irrespective of other prognostic markers or treatment administered.

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