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Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic…

Overview of attention for article published in Medical Oncology, March 2015
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Title
Satisfactory outcome after intensive chemotherapy with pragmatic use of minimal residual disease (MRD) monitoring in older patients with Philadelphia-negative B cell precursor acute lymphoblastic leukaemia: a Swedish registry-based study
Published in
Medical Oncology, March 2015
DOI 10.1007/s12032-015-0582-2
Pubmed ID
Authors

Emma Bergfelt, Piotr Kozlowski, Lucia Ahlberg, Erik Hulegårdh, Hans Hägglund, Karin Karlsson, Alicja Markuszewska-Kuczymska, Beata Tomaszewska-Toporska, Bengt Smedmyr, Maria Åström, Rose-Marie Amini, Heléne Hallböök

Abstract

The introduction of minimal residual disease (MRD) monitoring, in the Swedish national guidelines for acute lymphoblastic leukaemia, was evaluated in 35 patients aged 46-79 years (median 61), who were diagnosed from 2007 to 2011 and treated with high-intensity, block-based chemotherapy (ABCDV/VABA induction). Both a high complete remission rate (91 %) and acceptable overall survival (OS) rate (47 %) at 5 years were achieved. MRD by flow cytometry was measured in 73 % of the patients reaching complete remission after the first course, but was omitted by the clinicians for eight patients who were either over 70 years of age or already met conventional high-risk criteria. Factors negatively influencing OS were age over 65 years and WHO status ≥2. MRD < 0.1 % after induction had positive impact on continuous complete remission but not on OS. Only five patients were allocated to allogeneic haematopoietic stem cell transplantation in first remission, mainly due to conventional high risk factors. Thus, use of intensive remission induction therapy is effective in a selection of older patients. In a population for whom the possibilities of treatment escalation are limited, the optimal role of MRD monitoring remains to be determined.

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Mendeley readers

The data shown below were compiled from readership statistics for 13 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 13 100%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 3 23%
Other 1 8%
Student > Bachelor 1 8%
Professor 1 8%
Student > Ph. D. Student 1 8%
Other 4 31%
Unknown 2 15%
Readers by discipline Count As %
Medicine and Dentistry 9 69%
Agricultural and Biological Sciences 1 8%
Unknown 3 23%