Monitoring of Minimal XXXX After Allogeneic Stem-Cell Transplantation in Relapsed Childhood @entity981 Allows for the Identification of Impending Relapse: Results of the ALL-BFM-SCT 2003 Trial.

@entity1 @entity981 @entity66 @entity41 @entity7634
PURPOSE: To elucidate the impact of @entity41 ( @entity41 ) after allogeneic transplantation, the @entity981 Berlin-Frankfurt-M  nster Stem Cell Transplantation Group (ALL-BFM-SCT) conducted a prospective clinical trial. @entity1 AND METHODS: In the ALL-BFM-SCT 2003 trial, @entity41 was assessed in the bone marrow at days +30, +60, +90, +180, and +365 after transplantation in 113 @entity1 with @entity66 . Standardized quantification of @entity41 was performed according to the guidelines of the @entity7634 - @entity41 Group. RESULTS: All @entity1 showed a 3-year probability of event-free survival (pEFS) of 55%. The cumulative incidence rates of relapse and treatment-related mortality were 32% and 12%, respectively. The pEFS was 60% for @entity1 who received their transplantations in second complete remission, 50% for @entity1 in >=  third complete remission, and 0% for @entity1 not in remission (P = .015). At all time points, the level of @entity41 was inversely correlated with event-free survival (EFS; P < .004) and positively correlated with the cumulative incidence of relapse (P < .01). A multivariable Cox model was fitted for each time point, which showed that @entity41 >=  10(-4) leukemic cells was consistently correlated with inferior EFS (P < .003). The accuracy of @entity41 measurements in predicting relapse was investigated with time-dependent receiver operating curves at days +30, +60, +90, and +180. From day +60 onward, the discriminatory power of @entity41 detection to predict the probability of relapse after 1, 3, 6, and 9 months was more than 96%, more than 87%, more than 71%, and more than 61%, respectively. CONCLUSION: @entity41 after transplantation was a reliable marker for predicting impending relapses and could thus serve as the basis for pre-emptive therapy.
