Impact of timely monitoring before allogeneic stem cell transplantation among patients with -positive B-acute lymphoblastic leukemia.

BACKGROUND

With the emergence of tyrosine kinase inhibitors and the incorporation of stringent measurable residual disease (MRD) monitoring, risk stratification for -positive acute lymphoblastic leukemia (ALL) patients has changed significantly. However, whether this monitoring can replace conventional risk factors in determining whether patients need allogeneic stem cell transplantation is still unclear. This study aimed to determine the impact of monitoring on the outcome of patients with -positive ALL after allogeneic stem cell transplantation.

METHODS

We retrospectively analyzed the survival outcome of patients with -positive ALL based on the quantification of at 3 timepoints: the end of induction (timepoint 1), post-consolidation week 16 (timepoint 2), and the end of treatment for patients who were either transplant-eligible or non-transplant eligible (timepoint 3).

RESULTS

From 2006 to 2018, a total of 96 patients newly diagnosed with -positive ALL were treated with chemotherapy and tyrosine kinase inhibitors. Thirty-eight (41.3%) patients achieved complete remission, and 33 patients underwent allogeneic stem cell transplantation. Our data showed that pre-transplant MRD monitoring by real-time quantitative polymerase chain reaction had the highest correlation with survival in patients with -positive ALL, especially for those who underwent allogeneic stem cell transplantation.

CONCLUSION

Patients without MRD pre-transplantation had superior survival compared with those who had MRD, and they had excellent long-term outcomes after allogeneic stem cell transplantation.