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 bone marrow cells 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.

Persistence of minimal residual disease in bone marrow predicts outcome in follicular lymphomas treated with a rituximab-intensive program / Ladetto, M; Lobetti Bodoni, C; Mantoan, B; Ceccarelli, M; Boccomini, C; Genuardi, E; Chiappella, A; Baldini, L; Rossi, G; Pulsoni, A; Di Raimondo, F; Rigacci, L; Pinto, A; Galimberti, S; Bari, A; Rota Scalabrini, D; Ferrari, A; Zaja, F; Gallamini, A; Specchia, G; Musto, P; Rossi, Fg; Gamba, E; Evangelista, A; Vitolo, U; Raimondo, F; Chiarenza, A; Rigacci, L; Puccini, B; Bosi, Alberto. - In: BLOOD. - ISSN 0006-4971. - ELETTRONICO. - 122:(2013), pp. 3759-3766. [10.1182/blood-2013-06-507319]

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

BOSI, ALBERTO
2013

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 bone marrow cells 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.
2013
122
3759
3766
Ladetto, M; Lobetti Bodoni, C; Mantoan, B; Ceccarelli, M; Boccomini, C; Genuardi, E; Chiappella, A; Baldini, L; Rossi, G; Pulsoni, A; Di Raimondo, F; Rigacci, L; Pinto, A; Galimberti, S; Bari, A; Rota Scalabrini, D; Ferrari, A; Zaja, F; Gallamini, A; Specchia, G; Musto, P; Rossi, Fg; Gamba, E; Evangelista, A; Vitolo, U; Raimondo, F; Chiarenza, A; Rigacci, L; Puccini, B; Bosi, Alberto
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1046267
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