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Prognostic value of minimal residual disease measured by fusion-gene transcript in infants with KMT2A-rearranged acute lymphoblastic leukaemia treated according to the MLL-Baby protocol.

Grigory A TsaurAlexander M PopovTatiana RigerAnatoly KustanovichAlexander SolodovnikovEgor ShorikovAnna DeminaTatiana VerzhbitskayaOlga StrenevaOlga MakarovaElena LapotentovaOlga AleinikovaNatalia MiakovaElmira BoichenkoKonstantin KondratchikNatalia PonomarevaAlexander KarachunskiyAlexander RoumiantsevLarisa Fechina
Published in: British journal of haematology (2021)
The prognostic value of minimal residual disease (MRD) measured by fusion-gene transcript (FGT) detection was investigated in 76 infants (aged ≤1 year) with acute lymphoblastic leukaemia (ALL) with lysine methyltransferase 2A (KMT2A) rearrangements. Either at the end of induction or at later time-points, FGT-MRD-positivity was associated with poor outcome. FGT-MRD-positivity after first consolidation or first high-risk block detected 46·5% of infants with extremely poor outcome [disease-free survival (SE) 0·06 (0·06), cumulative incidence of relapse (SE) 0·91 (0·05)], which was also confirmed in multivariable analysis. Thus, FGT-MRD measurement at a single time-point clearly identifies infants with ALL who are curable with conventional chemotherapy and those who would benefit only from other treatment approaches.
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