TY  - JOUR
A1  - Rettinger, Eva
A1  - Merker, Michael
A1  - Salzmann-Manrique, Emilia
A1  - Kreyenberg, Hermann
A1  - Krenn, Thomas
A1  - Dürken, Matthias
A1  - Faber, Jörg
A1  - Hünecke, Sabine
A1  - Cappel, Claudia
A1  - Bremm, Melanie
A1  - Willasch, Andre Manfred
A1  - Bakhtiar, Shahrzad
A1  - Jarisch, Andrea
A1  - Sörensen, Jan
A1  - Klingebiel, Thomas
A1  - Bader, Peter
T1  - Pre-emptive immunotherapy for clearance of molecular disease in childhood acute lymphoblastic leukemia after transplantation
T2  - Biology of blood and marrow transplantation
N2  - Monitoring of minimal residual disease (MRD) or chimerism may help guide pre-emptive immunotherapy (IT) with a view to preventing relapse in childhood acute lymphoblastic leukemia (ALL) after transplantation. Patients with ALL who consecutively underwent transplantation in Frankfurt/Main, Germany between January 1, 2005 and July 1, 2014 were included in this retrospective study. Chimerism monitoring was performed in all, and MRD assessment was performed in 58 of 89 patients. IT was guided in 19 of 24 patients with mixed chimerism (MC) and MRD and by MRD only in another 4 patients with complete chimerism (CC). The 3-year probabilities of event-free survival (EFS) were .69 ± .06 for the cohort without IT and .69 ± .10 for IT patients. Incidences of relapse (CIR) and treatment-related mortality (CITRM) were equally distributed between both cohorts (without IT: 3-year CIR, .21 ± .05, 3-year CITRM, .10 ± .04; IT patients: 3-year CIR, .18 ± .09, 3-year CITRM .13 ± .07). Accordingly, 3-year EFS and 3-year CIR were similar in CC and MC patients with IT, whereas MC patients without IT experienced relapse. IT was neither associated with an enhanced immune recovery nor an increased risk for acute graft-versus-host disease. Relapse prevention by IT in patients at risk may lead to the same favorable outcome as found in CC and MRD-negative-patients. This underlines the importance of excellent MRD and chimerism monitoring after transplantation as the basis for IT to improve survival in childhood ALL.
KW  - Allogeneic hematopoietic stem
KW  - cell transplantation
KW  - Chimerism
KW  - Minimal residual disease
KW  - Pre-emptive immunotherapy
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/45682
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-456829
SN  - 1523-6536
SN  - 1083-8791
N1  - Under a Creative Commons license
VL  - 23
IS  - 1
SP  - 87
EP  - 95
PB  - Elsevier Health Sciences
CY  - [s. l.]
ER  -