Minimal Residual Disease Negativity Predicts Prognosis in Mantle Cell Lymphoma

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MRD negativity is the greatest independent predictor of prognosis in mantle cell lymphoma.
MRD negativity is the greatest independent predictor of prognosis in mantle cell lymphoma.

SAN FRANCISCO—Achievement and preservation of minimal residual disease (MRD) negativity is the greatest independent predictor of prognosis in patients with mantle cell lymphoma, a study (Abstract 147) presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition has shown.

For the study, researchers prospectively monitored MRD in patients with mantle cell lymphoma in complete or partial remission 6 months after autologous stem cell transplantation (ASCT) or end of induction following completion of induction therapy and every 3 months after autologous stem cell transplantation or twice monthly during maintenance therapy until disease progression.

Researchers compared MRD results with clinical outcome. Patients were considered to have MRD negativity if they had a negative RQ-PCR result with a sensitivity greater than or equal to 10E-4. During follow-up, MRD status in peripheral blood was negative if there were solely negative values or positive if one positive MRD value was obtained during a 6-month period.

Results showed that among 406 evaluable patients (67% of patients in the study; 225 younger and 151 elderly patients) in remission 6 months after ASCT or end of induction, a positive MRD status in peripheral blood, independent of baseline MIPI score, was strongly associated with a shorter progression-free survival.

Therefore, MRD's value for prognosis was observed in both MCL Younger and MCL Elderly. In addition, analyses demonstrated a high association between low-level and shortened progression-free survival. Furthermore, in 76 relapsed patients, MRD analyses showed a strong association between MRD positivity and clinical relapse.

“Achievement and preservation of MRD response is a strong independent predictor of prognosis in mantle cell lymphoma and correlates significantly with long-term survival,” Christiane Pott, MD, PhD, from the University Hospital Schleswig-Holstein in Kiel, Germany, said while presenting at the meeting.

“MRD response should be integrated into current response criteria as it more precisely defines prognosis than clinical response alone. Treatment strategies focusing on MRD eradication should [also] be part of future clinical trials,” Dr. Pott concluded.

  1. Pott, Christiane, MD, PhD. "147 MRD Eradication Should be the Therapeutic Goal in Mantle Cell Lymphoma and May Enable Tailored Treatment Approaches: Results of the Intergroup Trials of the European MCL Network." ASH 2014. Oral Presentation. December 7, 2014.

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