Minimal residual disease (MRD) assessment improves prediction of progression-free survival for patients with chronic lymphocytic leukemia (CLL) who achieve a complete remission or partial response, according to a study published in the Journal of Clinical Oncology.1
MRD refers to the leukemic cells that persist during treatment or while the patient is in remission, and explains why many patients relapse. The value of MRD for predicting clinical outcome, however, is unclear.
Investigators analyzed MRD and clinical response data from 554 patients with CLL treated with chemotherapy, with or without rituximab, who were included in 2 randomized phase 3 trials.
Patients with MRD-negative complete remission, MRD-negative partial response, MRD-positive complete remission, and MRD-positive partial response had a median progression-free survival of 61 months, 54 months, 35 months, and 21 months, respectively.
There was no significant difference in progression-free survival among patients with MRD-negative complete remission and those with MRD-negative partial response. In contrast, progression-free survival was significantly longer for patients with MRD-negative partial response, compared with those with MRD-positive complete remission.
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Researchers also found that, unlike persisting lymphadenopathy, residual splenomegaly does not affect progression-free survival among patients with MRD-negative partial response.
- Kovacs G, Robrecht S, Fink AM, et al. Minimal residual disease assessment improves prediction of outcome in patients with chronic lymphocytic leukemia (CLL) who achieve partial response: Comprehensive analysis of two phase III studies of the German CLL Study Group. J Clin Oncol. 2016 Aug 29. doi: 10.1200/JCO.2016.67.1305 [Epub ahead of print]