How Does MRD Negativity Affect Outcomes in Newly Diagnosed Ph+ ALL?

Measurable residual disease (MRD)-negative complete remission (CR) can predict long-term survival in patients with newly diagnosed Philadelphia chromosome–positive acute lymphoblastic leukemia (Ph+ ALL), according to a study presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas.

During a systemic literature review, the researchers identified nine studies with data from 704 total patients. They used all nine studies for an aggregate study-level meta-analysis, and three for an individual patient data (IPD) meta-analysis. The researchers looked at outcomes such as event-free survival (EFS), overall survival (OS), and MRD or MRD-negative CR at the end of induction.

According to the IPD analysis, MRD-negative CR at the end of induction was predictive of long-term EFS or OS. Patients in CR with deeper molecular response and those with MRD-negative CR (BCR::ABL1/ABL1 ≤0.01%) at the end of induction had “significantly better” long-term EFS and OS compared with patients with other MRD levels.

For patients who achieved MRD-negative CR, the median EFS was 77.67 months (26.64 to not evaluable [NE]), and the median OS was NE (46.62 to NE). For patients who achieved CR, the median EFS was 23.89 months (17.05–31.70), and the median OS was 46.49 months (34.63–82.89). These findings were consistent with the aggregate study-level meta-analysis.

“MRD-negative CR has greater prognostic value than CR alone and is strongly associated with long-term EFS and OS in adult patients with newly diagnosed Ph+ ALL,” the researchers concluded.

Reference

Ashaye A, Chalandon Y, Boissel N, et al. Minimal residual disease–negative complete remission at the end of induction is a prognostic indicator of long-term survival in adult patients with Philadelphia chromosome–positive acute lymphoblastic leukemia receiving first-line therapy. Abstract #ALL-438. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; September 4-7, 2024; Houston, Texas.