| Added by | mollevi |
|---|---|
| Last modified by | Nathalie Bonnefoy |
| Group name | EquipeNB |
| Item Type | Journal Article |
| Title | Follow-up of post-transplant minimal residual disease and chimerism in childhood lymphoblastic leukaemia: 90 d to react |
| Creator | Pochon et al. |
| Author | C. Pochon |
| Author | E. Oger |
| Author | G. Michel |
| Author | J. H. Dalle |
| Author | A. Salmon |
| Author | B. Nelken |
| Author | Y. Bertrand |
| Author | H. Cave |
| Author | J. M. Cayuela |
| Author | N. Grardel |
| Author | E. Macintyre |
| Author | G. Margueritte |
| Author | F. Mechinaud |
| Author | P. Rohrlich |
| Author | C. Paillard |
| Author | F. Demeocq |
| Author | P. Schneider |
| Author | D. Plantaz |
| Author | M. Poiree |
| Author | J. F. Eliaou |
| Author | G. Semana |
| Author | S. Drunat |
| Author | P. Jonveaux |
| Author | P. Bordigoni |
| Author | V. Gandemer |
| Abstract | Relapse after transplantation is a major cause of treatment failure in paediatric acute lymphoblastic leukaemia (ALL). Here, we report the findings of a prospective national study designed to investigate the feasibility of immune intervention in children in first or subsequent remission following myeloablative conditioning. This study included 133 children who received a transplant for ALL between 2005 and 2008. Minimal Residual Disease (MRD) based on T cell receptor/immunoglobulin gene rearrangements was measured on days -30, 30, 90 and 150 post-transplantation. Ciclosporin treatment was rapidly discontinued and donor lymphocyte infusions (DLI) were programmed for patients with a pre- or post-transplant MRD status >/=10(-3) . Only nine patients received DLI. Pre- and post-transplant MRD status, and the duration of ciclosporin were independently associated with 5-year overall survival (OS), which was 62.07% for the whole cohort. OS was substantially higher in patients cleared of MRD than in those with persistent MRD (52.3% vs. 14.3%, respectively). Only pre-transplant MRD status (Hazard Ratio 2.57, P = 0.04) and duration of ciclosporin treatment (P < 0.001) were independently associated with relapse. The kinetics of chimerism were not useful for predicting relapse, whereas MRD monitoring up to 90 d post-transplantation was a valuable prognostic tool to guide therapeutic intervention. |
| Publication | Br J Haematol |
| Volume | 169 |
| Pages | 249-61 |
| Date | Apr 2015 |
| Journal Abbr | British journal of haematology |
| DOI | 10.1111/bjh.13272 |
| ISSN | 1365-2141 (Electronic) 0007-1048 (Linking) |
| Tags | *Hematopoietic Stem Cell Transplantation/adverse effects, *Transplantation Chimera, Adoptive Transfer, Child, clinic, Female, Follow-Up Studies, Graft vs Host Disease/etiology, Humans, Lymphocytes, Male, Neoplasm, Residual, Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality/*pathology/therapy, Prognosis, Proportional Hazards Models, Tissue Donors, Treatment Outcome |
| Date Added | 2018/11/14 - 12:04:32 |
| Date Modified | 2019/05/28 - 22:07:43 |
| Notes and Attachments | (Note) (Note) 25522886 (Attachment) |
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