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 / M. Ladetto, C. Lobetti-Bodoni, B. Mantoan, M. Ceccarelli, C. Boccomini, E. Genuardi, A. Chiappella, L. Baldini, G. Rossi, A. Pulsoni, F. Di Raimondo, L. Rigacci, A. Pinto, S. Galimberti, A. Bari, D. Rota-Scalabrini, A. Ferrari, F. Zaja, A. Gallamini, G. Specchia, P. Musto, F.G. Rossi, E. Gamba, A. Evangelista, U. Vitolo. - In: BLOOD. - ISSN 0006-4971. - 122:23(2013 Nov 28), pp. 3759-3766.
|Titolo:||Persistence of minimal residual disease in bone marrow predicts outcome in follicular lymphomas treated with a rituximab-intensive program|
|Parole Chiave:||Aged; Antibodies Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Consolidation Chemotherapy; Disease-Free Survival; Female; Humans; Lymphoma Follicular; Male; Middle Aged; Neoplasm Residual; Oncogene Proteins Fusion; Prognosis|
|Settore Scientifico Disciplinare:||Settore MED/15 - Malattie del Sangue|
|Data di pubblicazione:||28-nov-2013|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1182/blood-2013-06-507319|
|Appare nelle tipologie:||01 - Articolo su periodico|