TY - JOUR
T1 - Persistence of minimal residual disease in bone marrow predicts outcome in follicular lymphomas treated with a rituximab-intensive program
AU - Ladetto, Marco
AU - Lobetti-Bodoni, Chiara
AU - Mantoan, Barbara
AU - Ceccarelli, Manuela
AU - Boccomini, Carola
AU - Genuardi, Elisa
AU - Chiappella, Annalisa
AU - Baldini, Luca
AU - Rossi, Giuseppe
AU - Pulsoni, Alessandro
AU - Di Raimondo, Francesco
AU - Rigacci, Luigi
AU - Pinto, Antonello
AU - Galimberti, Sara
AU - Bari, Alessia
AU - Rota-Scalabrini, Delia
AU - Ferrari, Angela
AU - Zaja, Francesco
AU - Gallamini, Andrea
AU - Specchia, Giorgina
AU - Musto, Pellegrino
AU - Rossi, Francesca Gaia
AU - Gamba, Enrica
AU - Evangelista, Andrea
AU - Vitolo, Umberto
PY - 2013/11/28
Y1 - 2013/11/28
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84891043722&partnerID=8YFLogxK
U2 - 10.1182/blood-2013-06-507319
DO - 10.1182/blood-2013-06-507319
M3 - Article
SN - 0006-4971
VL - 122
SP - 3759
EP - 3766
JO - Blood
JF - Blood
IS - 23
ER -