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La enfermedad mínima residual (EMR) demostró ser un factor pronóstico independiente de riesgo de recaída, permitiendo la adecuación del tratamiento según grupos de riesgo(1). Entre junio de 2010 y mayo de 2019 se evaluaron 137 pacientes (p) pediátricos con diagnóstico de novo de leucemia linfoblástica aguda (LLA), tratados de acuerdo al protocolo ALLIC BFM-GATLA 2010, incluyendo la EMR al día 15 para estratificar grupos de riesgo. El punto de corte utilizado para definir EMR al día 15 positiva fue 0.1 %. La EMR al día 15 > 0.1% (87 p, 63%) se asoció con recaídas, no así con SLE y SG. La EMR al día 33 > 0,05 (20 p) se asoció significativamente con riesgo, recaída, SG y SLE. La SG a 24 meses de pacientes EMR al día 33 (-)/al día 72 (-) fue 88%, EMR al día 33 (+)/al día 72 (-) 71% y EMR al día 33 (+)/al día 72 (+) 40% (p= 0.001). La SLE a 24 meses fue 89%, 61% y 40% (p= 0.000) para los mismos grupos de pacientes. La EMR al día 33 ≥ 0.05 fue la única variable independiente asociada a recaída (p= 0,02), hazard risk (HR) 4.1 (IC 95 1.72-10.055), lo que muestra que tener EMR + al día 33 aumenta 4 veces el riesgo de recaída.
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