Table 3. Outcomes of Patients (at 5 Years) Receiving Different PRT Based on Dynamics of MRD1, MRD2, and MRD3.
| MRD status and PRT | No. | % (95% CI) | |||||
|---|---|---|---|---|---|---|---|
| Overall survival | Leukemia-free survival | CIR | TRM | GRFS | |||
| Subgroup Aa | |||||||
| CMT | 55 | 93.6 (81.5-98.0) | 87.3 (75.2-93.7) | 12.7 (5.5-23.0) | 0 | 87.3 (75.2-93.7) | |
| Auto-SCT | 37 | 97.3 (82.3-99.6) | 97.3 (82.3-99.6) | 2.7 (0.2-12.3) | 0 | 97.3 (82.3-99.6) | |
| Allo-SCT | 41 | 88.5 (68.4-96.1) | 90.3 (76.1-96.2) | 2.4 (0.2-11.2) | 7.3 (1.9-18.0) | 70.7 (54.3-82.2) | |
| P value | .40 | .27 | .07 | .03b | .003 | ||
| Subgroup B | |||||||
| CMT | 21 | 14.3 (3.6-32.1) | 4.8 (0.3-19.7) | 90.5 (59.8-98.1) | 4.7 (0.3-20.5) | 4.8 (0.3-19.7) | |
| Auto-SCT | 16 | 37.5 (15.4-59.8) | 25.0 (7.8-47.2) | 68.8 (38.0-86.5) | 6.3 (0.4-25.7) | 25.0 (7.8-47.2) | |
| Allo-SCT | 77 | 64.9 (53.2-74.4) | 61.0 (49.2-70.9) | 26.0 (16.7-36.2) | 13.0 (6.6-21.6) | 44.2 (32.9-54.8) | |
| P value | <.001 | <.001 | <.001 | .48 | <.001 | ||
| Subgroup C | |||||||
| CMT | 22 | 27.3 (11.1-46.4) | 18.2 (5.7-36.3) | 81.8 (56.4-93.2) | 0 | 18.2 (5.7-36.3) | |
| Auto-SCT | 17 | 41.2 (18.6-62.6) | 35.3 (14.5-57.0) | 52.9 (26.2-73.9) | 11.8 (1.8-32.0) | 35.3 (14.5-57.0) | |
| Allo-SCT | 31 | 71.0 (51.6-83.7) | 67.7 (48.4-81.2) | 22.6 (9.8-38.6) | 9.7 (2.4-23.2) | 48.4 (30.2-64.4) | |
| P value | .02 | .001 | <.001 | .28 | .10 | ||
| Subgroup D | |||||||
| CMT | 35 | 51.4 (34.0-66.4) | 45.7 (28.9-61.1) | 51.4 (33.6-66.7) | 2.9 (0.2-13.0) | 45.7 (28.9-61.1) | |
| Auto-SCT | 38 | 86.8 (71.2-94.3) | 78.9 (62.3-88.9) | 21.1 (9.8-35.2) | 0 | 78.9 (62.3-88.9) | |
| Allo-SCT | 85 | 87.1 (77.9-92.6) | 84.7 (75.1-90.8) | 5.9 (2.2-12.3) | 9.4 (4.4-16.8) | 64.5 (53.3-73.7) | |
| P value | <.001 | <.001 | <.001 | .08c | .03 | ||
| Subgroup E | |||||||
| CMT | 21 | 45.8 (23.4-65.8) | 33.3 (14.9-53.1) | 66.7 (41.2-83.1) | 0 | 33.3 (14.9-53.1) | |
| Auto-SCT | 8 | 62.5 (22.9-86.1) | 50.0 (15.2-77.5) | 37.5 (7.0-69.7) | 12.5 (0.4-45.3) | 50.0 (15.2-77.5) | |
| Allo-SCT | 45 | 77.8 (62.6-87.4) | 77.8 (62.6-87.4) | 11.1 (4.0-22.3) | 11.1 (4.0-22.3) | 55.6 (40.0-68.6) | |
| P value | .02 | <.001 | <.001 | .29 | .14 | ||
Abbreviations: allo-SCT, allogeneic stem cell transplant; auto-SCT, autologous stem cell transplant; CIR, cumulative incidence of relapse; CMT, chemotherapy; GRFS, graft-vs-host disease–free, relapse-free survival; MRD, measurable residual disease; MRD1, measurable residual disease after 1 course of CMT; MRD2, measurable residual disease after 2 courses of CMT; MRD3, measurable residual disease after 3 courses of CMT; PRT, postremission treatment; TRM, transplant-related mortality.
Subgroup A, patients who became MRD negative after 1 course of CMT and were persistently MRD negative; subgroup B, persistently positive MRD; subgroup C, recurrent MRD-positive patients after being MRD negative; subgroup D, patients who become MRD negative after 2 courses of CMT; and subgroup E, patients who become MRD negative after 3 courses of CMT.
CMT vs allo-SCT (P = .04) and auto-SCT vs allo-SCT (P = .09).
Auto-SCT vs allo-SCT (P = .04).