Using Minimal Residual Disease to Improve Treatment Response Definitions and Hematopoietic Cell Transplantation Strategy in Acute Leukemia
Menée à partir de données portant sur 359 adultes atteints d'une leucémie myéloïde aiguë et ayant reçu une greffe allogénique de cellules souches hématopoïétiques avec conditionnement myéloablatif entre 2006 et 2014, cette étude analyse la relation entre présence résiduelle de la maladie avant la greffe, rémission complète et risque de récidive ou survie globale à trois ans
Acute leukemia is a most challenging illness for the onco-hematologist because of the high risk of life-threatening complications and the complexity of treatment protocols as well as the uncertain therapeutic outcome, which depends on several host-, disease- and treatment-related factors. When cure is the goal, as is normally the case for fit patients younger than 60 to 65 years with either acute myelogenous leukemia (AML) or acute lymphoblastic leukemia (ALL), the general plan is to deliver an intensive multidrug induction and postinduction treatment sequence, in which the greatest intensity, whenever required, is provided by an allogeneic hematopoietic cell transplantation (HCT). For the assessment of treatment response, a set of standard criteria was developed several years ago by a panel of experts, well before the current explosion of sophisticated technologies to assess residual disease status. In accordance, the bone marrow morphology is checked after induction chemotherapy to confirm the achievement of complete remission (CR), which is defined by a marrow blast cell content of less than 5%, together with the recovery of normal blood cell counts.
Journal of Clinical Oncology , éditorial en libre accès, 2015