Independent prognostic significance of minimal residual disease status in chronic lymphocytic leukaemia

摘要: Abstract Background Eradication of minimal residual disease (MRD) is an independent predictor survival outcome in patients with chronic lymphocytic leukaemia (CLL) receiving fludarabine and cyclophosphamide (FC) or fludarabine, cyclophosphamide, rituximab (FCR) as first-line treatment. However, the prognostic relevance MRD status other therapeutic settings not clear. The goal this study was to investigate importance achieving negativity CLL on progression-free (PFS) overall (OS) different treatments frontline relapsed refractory compared known markers. Methods We included all at our centre Leeds associated hospitals West North Yorkshire who had completed treatment for from 1996 2007, achieved least a partial response, received assessment bone-marrow specimen after assessments were done by multiparametric flow cytometry using CD5–CD19 combination CD20, CD22, CD32, CD38, CD79b, CD81 accordance international harmonised approach. 133 (17 65 fludarabine-based therapies, 26 alemtuzumab, 25 including chlorambucil autologous stem-cell transplantation) followed up median 5·2 years (IQR 3·0–7·3) assess PFS OS. Findings (defined less than one cell 10 000 leucocytes) end therapy independently correlated both (hazard ratio [HR] 3·22 [95% CI 2·09–4·97], Cox proportional hazards model p vs 31) OS (78 64) did MRD-positive individuals without such adverse cytogenetic abnormalities. Interpretation powerful across range approaches relapse settings. most appropriate are fit enough Funding None.