Language

English

Publication Date

5-16-2024

Journal

Blood

DOI

10.1182/blood.2023021184

PMID

38457359

PMCID

PMC11143515

PubMedCentral® Posted Date

3-13-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Defining prognostic variables in T-lymphoblastic lymphoma (T-LL) remains a challenge. AALL1231 was a Children’s Oncology Group phase 3 clinical trial for newly diagnosed patients with T acute lymphoblastic leukemia or T-LL, randomizing children and young adults to a modified augmented Berlin-Frankfurt-Münster backbone to receive standard therapy (arm A) or with addition of bortezomib (arm B). Optional bone marrow samples to assess minimal residual disease (MRD) at the end of induction (EOI) were collected in T-LL analyzed to assess the correlation of MRD at the EOI to event-free survival (EFS). Eighty-six (41%) of the 209 patients with T-LL accrued to this trial submitted samples for MRD assessment. Patients with MRD < 0.1% (n = 75) at EOI had a superior 4-year EFS vs those with MRD ≥0.1% (n = 11) (89.0% ± 4.4% vs 63.6% ± 17.2%; P = .025). Overall survival did not significantly differ between the 2 groups. Cox regression for EFS using arm A as a reference demonstrated that MRD EOI ≥0.1% was associated with a greater risk of inferior outcome (hazard ratio, 3.73; 95% confidence interval, 1.12-12.40; P = .032), which was independent of treatment arm assignment. Consideration to incorporate MRD at EOI into future trials will help establish its value in defining risk groups. CT# NCT02112916.

Keywords

Humans, Neoplasm, Residual, Child, Female, Male, Adolescent, Child, Preschool, Precursor T-Cell Lymphoblastic Leukemia-Lymphoma, Antineoplastic Combined Chemotherapy Protocols, Bortezomib, Young Adult, Disease-Free Survival, Adult, Infant, Prognosis

Published Open-Access

yes

BLOOD_BLD-2023-021184-ga1.jpg (454 kB)
Graphical Abstract

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