Autor/a:
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Santacruz, Rodrigo; Villamor i Casas, Neus; Aymerich Gregorio, Marta; Martínez Trillos, Alejandra; López, Cristina; Navarro López, Alba; Rozman, María; Beà Bobet, Sílvia M.; Royo Moreno, Cristina; Cazorla, Maite; Colomer Pujol, Dolors; Giné Soca, Eva; Pinyol, Magda; Puente, Xose S.; López-Otín, Carlos; Campo Güerri, Elias; López Guillermo, Armando; Delgado, Julio (Delgado González)
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Abstract:
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A proportion of patients with chronic lymphocytic leukemia achieve a minimal residual disease negative status after therapy. We retrospectively evaluated the impact of minimal residual disease on the outcome of 255 consecutive patients receiving any front-line therapy in the context of a detailed prognostic evaluation, including assessment of IGHV, TP53, NOTCH1 and SF3B1 mutations. The median follow-up was 73 months (range, 2-202) from disease evaluation. The median treatment-free survival durations for patients achieving a complete response without or with minimal residual disease, a partial response and no response were 76, 40, 11 and 11 months, respectively (P<0.001). Multivariate analysis revealed that three variables had a significant impact on treatment-free survival: minimal residual disease (P<0.001), IGHV status (P<0.001) and β2-microglobulin levels (P=0.012). With regards to overall survival, factors predictive of an unfavorable outcome were minimal residual disease positivity (P=0.014), together with advanced age (P<0.001), unmutated IGHV status (P=0.001), TP53 mutations (P<0.001) and elevated levels of β2-microglobulin (P=0.003). In conclusion, for patients requiring front-line therapy, achievement of minimal residual disease negativity is associated with significantly prolonged treatment-free and overall survival irrespective of other prognostic markers or treatment administered. |