Persistence of minimal residual disease in bone marrow predicts outcome in follicular lymphomas treated with a rituximab-intensive program

Marco Ladetto, Chiara Lobetti-Bodoni, Barbara Mantoan, Manuela Ceccarelli, Carola Boccomini, Elisa Genuardi, Annalisa Chiappella, Luca Baldini, Giuseppe Rossi, Alessandro Pulsoni, Francesco Di Raimondo, Luigi Rigacci, Antonello Pinto, Sara Galimberti, Alessia Bari, Delia Rota-Scalabrini, Angela Ferrari, Francesco Zaja, Andrea Gallamini, Giorgina SpecchiaPellegrino Musto, Francesca Gaia Rossi, Enrica Gamba, Andrea Evangelista, Umberto Vitolo

Research output: Contribution to journalArticlepeer-review

Abstract

We assessed the prognostic value of minimal residual disease (MRD) within the ML17638 phase 3 trial from the Fondazione Italiana Linfomi, investigating the role of rituximab maintenance in elderly follicular lymphoma (FL) patients after a brief first-line chemoimmunotherapy. MRD for the bcl-2/IgH translocation was determined on bonemarrowcells in a centralized laboratory belonging to the Euro-MRD consortium, using qualitative and quantitative polymerase chain reactions (PCRs). Of 234 enrolled patients, 227 (97%) were screened at diagnosis. A molecular marker (MM) was found in 51%. Patients with an MM were monitored at 8 subsequent times. Of the 675 expected follow-up samples, 83% were analyzed. Conversion to PCR negativity predicted better progression-free survival (PFS) at all post-treatment times (eg, end of therapy: 3-year PFS, 72% vs 39%; P < .007). MRD was predictive in both maintenance (83% vs 60%; P < .007) and observation (71% vs 50%; P < .001) groups. PCR positivity at the end of induction was an independent adverse predictor (hazard ratio, 3.1; 95% confidence interval, 1.36-7.07). MRD is a powerful independent outcome predictor in FL patients who receive rituximab-intensive programs, suggesting a need to investigate its value for decision-making. This trial was registered at www.clinicaltrial.gov as #NCT01144364.

Original languageEnglish
Pages (from-to)3759-3766
Number of pages8
JournalBlood
Volume122
Issue number23
DOIs
Publication statusPublished - 28 Nov 2013
Externally publishedYes

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