Prognostic Value Of Minimal Residual Disease Measured By Fusion-Gene Transcript In Infants With Kmt2a-Rearranged Acute Lymphoblastic Leukaemia Treated According To The Mll-Baby Protocol

The prognostic value of minimal residual disease (MRD) measured by fusion-gene transcript (FGT) detection was investigated in 76 infants (aged <= 1 year) with acute lymphoblastic leukaemia (ALL) with lysine methyltransferase 2A (KMT2A) rearrangements. Either at the end of induction or at later time-points, FGT-MRD-positivity was associated with poor outcome. FGT-MRD-positivity after first consolidation or first high-risk block detected 46 center dot 5% of infants with extremely poor outcome [disease-free survival (SE) 0 center dot 06 (0 center dot 06), cumulative incidence of relapse (SE) 0 center dot 91 (0 center dot 05)], which was also confirmed in multivariable analysis. Thus, FGT-MRD measurement at a single time-point clearly identifies infants with ALL who are curable with conventional chemotherapy and those who would benefit only from other treatment approaches.