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Abstract
Minimal residual disease (MRD) has proven to be an independent predictor for risk of relapse, allowing the adequacy of treatment according to risk groups.
Between June 2010 and May 2019, 137 patients were evaluated with diagnosis of acute lymphoblastic leukemia treated using the ALLIC BFM-GATLA 2010 protocol. Evaluation at day 15 was used as indicator to stratify risk groups.
The cut-off used for MRD on day 15 was 0.1%. Although MRD > 0.1% (87 patients, 63%) was associated with risk and relapse, neither overall survival (OS) nor disease-free survival (DFS) has shown a significance correlation. Moreover, MRD at day 33 > 0.05% (20 patients) was highly associated with risk, relapse, OS and DFS. OS at month 24 for MRD day 33 negative/day 72 negative was 88%, MRD at day 33 positive/at day 72 negative was 71% and MRD at day 33 positive/at day 72 positive was 40% (p= 0.001).
DFS at month 24 for MRD at day 33 negative/at day 72 negative was 89%, MRD at day 33 positive/at day 72 negative was 61% and MRD at day 33 positive/at day 72 positive was 40% (p= 0.0001).
The MRD at day 33 with 0.05% or higher was the only that shows association with relapse (p 0.02),
hazard risk 4,1 (IC 95 1.72-10.055) which suggests that MRD day 33 positive increases 4 times the risk of relapse.
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