Studies on minimal residual disease (MRD) kinetics after allogeneic stem cell transplantation (alloSCT) for chronic lymphocytic leukemia (CLL) using quantitative MRD assays.
| . | Ritgen et al21 . | Farina et al18 . | Moreno et al23* . |
|---|---|---|---|
| * and C Moreno, personal communication, May 19, 2009 | |||
| a Fludarabine-cyclophosphamide; additional anti-thymocyte globulin (ATG) in unrelated donor transplants | |||
| b Fludarabine-cyclophosphamide-thiotepa; cyclophosphamide-thiotepa-antithymocyte globulin in unrelated donor transplants | |||
| c Cyclophosphamide, total body irradiation 12 Gy; or fludarabine, melphalan; or fludarabine, total body irradiation 2 Gy | |||
| d MRD– prior to CSA withdrawal or onset of chronic graft-versus-host disease (GVHD) | |||
| e MRD– only after CSA withdrawal, donor lymphocyte infusions (DLI), or onset of chronic GVHD | |||
| f Mixed: not consistently negative, but without significant increase over time | |||
| g Two patients had MRD recurrence concurrent with clinical relapse 33 and 62 months post alloSCT | |||
| h Including all patients with a “mixed” pattern | |||
| i Update March 31, 2009 | |||
| n | 28 | 29 | 20 |
| Conditioning regimen | FCy+/-ATGa | FCyTT/CyTT-ATGb | Cy/TBI, FMel, F/TBI2c |
| MRD quantification assay | RQ-PCR/MRD-Flow | Nested PCR/RQ-PCR | RQ-PCR/MRD-Flow |
| MRD pattern | |||
| Permanent negativity | 22 of 28 (79%) | 9 of 29 (31%) | 13 of 20 (65%) |
| Immediate negativityd | 4 of 28 (14%) | 5 of 29 (17%) | 3 of 20 (15%) |
| Delayed negativitye | 18 of 28 (64%) | 4 of 29 (14%) | 10 of 20 (50%) |
| Mixed patternf | 0 | 7 of 29 (24%) | 1 of 20 (5%) |
| Always positive | 6 of 28 (21%) | 13 of 29 (45%) | 6 of 20 (30%) |
| Relapse by MRD pattern | |||
| Permanent negativity | 1 (4%) | 0 | n.a. |
| Mixed pattern | n.a. | 1 (14%) | n.a. |
| Always positive | 5 (83%) | 8 (62%) | n.a. |
| Clinical relapse in patients MRD– | |||
| 12 months post SCTg | 1 of 19 (5%) | 0 of 15h | 1 of 9 (11%)e |
| Follow-up of MRD– patients (mo) | 72 (41–101)i | 40 (12–85) | (6–204) |
| . | Ritgen et al21 . | Farina et al18 . | Moreno et al23* . |
|---|---|---|---|
| * and C Moreno, personal communication, May 19, 2009 | |||
| a Fludarabine-cyclophosphamide; additional anti-thymocyte globulin (ATG) in unrelated donor transplants | |||
| b Fludarabine-cyclophosphamide-thiotepa; cyclophosphamide-thiotepa-antithymocyte globulin in unrelated donor transplants | |||
| c Cyclophosphamide, total body irradiation 12 Gy; or fludarabine, melphalan; or fludarabine, total body irradiation 2 Gy | |||
| d MRD– prior to CSA withdrawal or onset of chronic graft-versus-host disease (GVHD) | |||
| e MRD– only after CSA withdrawal, donor lymphocyte infusions (DLI), or onset of chronic GVHD | |||
| f Mixed: not consistently negative, but without significant increase over time | |||
| g Two patients had MRD recurrence concurrent with clinical relapse 33 and 62 months post alloSCT | |||
| h Including all patients with a “mixed” pattern | |||
| i Update March 31, 2009 | |||
| n | 28 | 29 | 20 |
| Conditioning regimen | FCy+/-ATGa | FCyTT/CyTT-ATGb | Cy/TBI, FMel, F/TBI2c |
| MRD quantification assay | RQ-PCR/MRD-Flow | Nested PCR/RQ-PCR | RQ-PCR/MRD-Flow |
| MRD pattern | |||
| Permanent negativity | 22 of 28 (79%) | 9 of 29 (31%) | 13 of 20 (65%) |
| Immediate negativityd | 4 of 28 (14%) | 5 of 29 (17%) | 3 of 20 (15%) |
| Delayed negativitye | 18 of 28 (64%) | 4 of 29 (14%) | 10 of 20 (50%) |
| Mixed patternf | 0 | 7 of 29 (24%) | 1 of 20 (5%) |
| Always positive | 6 of 28 (21%) | 13 of 29 (45%) | 6 of 20 (30%) |
| Relapse by MRD pattern | |||
| Permanent negativity | 1 (4%) | 0 | n.a. |
| Mixed pattern | n.a. | 1 (14%) | n.a. |
| Always positive | 5 (83%) | 8 (62%) | n.a. |
| Clinical relapse in patients MRD– | |||
| 12 months post SCTg | 1 of 19 (5%) | 0 of 15h | 1 of 9 (11%)e |
| Follow-up of MRD– patients (mo) | 72 (41–101)i | 40 (12–85) | (6–204) |