Table 3.
Combined risk stratification for assignment to risk-oriented therapy in Ph− ALL (n = 140).
| All patients (n = 140) |
T-ALL | B-ALL | ||||||
|---|---|---|---|---|---|---|---|---|
| All (n = 43) | SR (n = 11) | VHR (n = 32) | All (n = 97) | SR (n = 52) | HR (n = 16) | VHR (n = 29) | ||
| End of induction MRD (TP1), n (%) | ||||||||
| Evaluable | 92 | 33 (76.7) | 8 (72.7) | 25 (78.1) | 59 (60.8) | 32 (61.5) | 9 (56.3) | 18 (62.1) |
| Negative | 34 (37.0) | 15 (45.5) | 5 (62.5) | 10 (40.0) | 19 (32.2) | 13 (40.6) | 1 (11.1) | 5 (27.8) |
| <10–4 | 14 (15.2) | 4 (12.1) | 1 (12.5) | 3 (12.0) | 10 (16.9) | 6 (18.8) | 1 (11.1) | 3 (16.7) |
| ≥10–4 | 44 (47.8) | 14 (42.4) | 2 (25.0) | 12 (48.0) | 30 (50.8) | 13 (40.6) | 7 (77.8) | 10 (55.6) |
| Early consolidation MRD (TP2), n (%) | ||||||||
| Evaluable | 106 | 36 (83.7) | 10 (90.9) | 26 (81.3) | 70 (72.2) | 37 (71.2) | 14 (87.5) | 19 (65.5) |
| Negative | 64 (60.4) | 22 (61.1) | 8 (80.0) | 14 (53.8) | 42 (60.0) | 25 (67.6) | 6 (42.9) | 11 (57.9) |
| <10–4 | 11 (10.4) | 5 (13.9) | 1 (10.0) | 4 (15.4) | 6 (8.6) | 4 (10.8) | 2 (14.3) | 0 (0.0) |
| ≥10–4 | 31 (29.2) | 9 (25.0) | 1 (10.0) | 8 (30.8) | 22 (31.4) | 8 (21.6) | 6 (42.9) | 8 (42.1) |
| MRD risk modela, n (%) | ||||||||
| Evaluable | 109 (77.9) | 36 (83.7) | 10 (90.9) | 26 (81.3) | 73 (75.3) | 39 (75.0) | 14 (87.5) | 20 (69.0) |
| MRDpos | 41 (37.6) | 10 (27.8) | 2 (20.0) | 8 (30.8) | 31 (42.5) | 12 (30.8) | 8 (57.1) | 11 (55.0) |
| MRDneg | 68 (62.4) | 26 (72.2) | 8 (80.0) | 18 (69.2) | 42 (57.5) | 27 (69.2) | 6 (42.9) | 9 (45.0) |
| Allocation cohort, n (%) | ||||||||
| Maintenance | 55 (39.3) | 9 (20.9) | 9 (81.8) | – | 46 (47.4) | 40 (76.9) | 6 (37.5) | – |
| SR MRDneg | 35 (63.6) | 8 (88.9) | 8 (88.9) | – | 27 (58.7) | 27 (67.5) | – | – |
| SR MRDu/k | 14 (25.5) | 1 (11.1) | 1 (11.1) | – | 13 (28.3) | 13 (32.5) | – | – |
| HR MRDneg | 6 (10.9) | – | – | – | 6 (13.0) | – | 6 (100.0) | – |
| Allogeneic HCT | 85 (60.7) | 34 (79.1) | 2 (18.2) | 32 (100.0) | 51 (52.6) | 12 (23.1) | 10 (62.5) | 29 (100.0) |
| VHR | 61 (71.8) | 32 (94.1) | – | 32 (100.0) | 29 (56.9) | – | – | 29 (100.0) |
| HR MRDpos | 8 (9.4) | – | – | – | 8 (15.7) | – | 8 (80.0) | – |
| HR MRDu/k | 2 (2.4) | – | – | – | 2 (3.9) | – | 2 (20.0) | – |
| SR MRDpos | 14 (16.5) | 2 (5.9) | 2 (100.0) | – | 12 (23.5) | 12 (100.0) | – | – |
ALL acute lymphoblastic leukemia, SR standard risk, HR high-risk, VHR very high-risk, TP timepoint, MRD minimal residual disease, neg negative, pos positive, u/k unknown, HCT hematopoietic cell transplantation. MRD-based risk classification was available for 109 patients. Details of MRD analysis are shown for TP1 (end of induction) and TP2 according to ALL subset and clinical risk stratification (SR, HR, VHR). TP3 and TP4 MRD results are reported in supplemental file. MRD study results were obtained before any HCT.
aAs based on TP2, TP3, and TP4 MRD analysis.