Prospective evaluation of minimal residual disease monitoring to predict prognosis of adult patients with Ph-negative acute lymphoblastic leukemia

Koji Nagafuji, Toshihiro Miyamoto, Tetsuya Eto, Ryosuke Ogawa, Hirokazu Okumura, Ken Takase, Noriaki Kawano, Yasuhiko Miyazaki, Tomoaki Fujisaki, Atsushi Wake, Yuju Ohno, Toshiro Kurokawa, Tomohiko Kamimura, Yasushi Takamatsu, Shouhei Yokota, Koichi Akashi

Research output: Contribution to journalArticle


Objective: We investigated whether minimal residual disease (MRD) status in adult patients with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) is useful for decision on clinical indications for allogeneic hematopoietic stem cell transplantation (HSCT). Methods: We prospectively monitored MRD after induction and consolidation therapy in adult patients with Ph-negative ALL. Results: Among 103 adult ALL patients enrolled, 59 were Ph-negative, and MRD status was assessed in 51 patients. The probability of 3-year overall survival (OS) and disease-free survival (DFS) was 69% (95%CI 54-80) and 50% (95%CI 36-63), respectively. Patients who were MRD-negative after induction therapy (n = 15) had a significantly better 3-year DFS compared with those who were MRD-positive (n = 30; 73% vs 41%, P = 0.018). Patients who were MRD-positive after induction but became MRD-negative after consolidation chemotherapy C in the first course (n = 11) showed a significantly worse 3-year DFS compared with patients who were MRD-negative after induction chemotherapy A in the first course (45% vs 73%, P = 0.025). Conclusions: These results indicate that DFS of about 70% can be expected in MRD-negative patients after induction therapy, and the patients did not benefit from HSCT in 1CR. This study was registered with the UMIN Clinical Trials Registry (UMIN-CTR), number UMIN000001519.

Original languageEnglish
Pages (from-to)164-171
Number of pages8
JournalEuropean Journal of Haematology
Issue number3
Publication statusPublished - Jan 1 2019


All Science Journal Classification (ASJC) codes

  • Hematology

Cite this