T-ALL Minimal Residual Disease Using a Simplified Gating Strategy and Its Clinico-hematologic Correlation: A Single...

Area of Science:

• Hematology
• Immunology
• Oncology

Background:

• Minimal residual disease (MRD) is a key prognostic factor in hematological malignancies like B-acute lymphoblastic leukemia (B-ALL) and T-ALL.
• Limited Indian data exists on MRD detection via flow cytometry in T-ALL, particularly concerning gating strategies and clinical correlations.

Purpose of the Study:

• To investigate the clinico-hematologic characteristics and prognostic significance of early T-cell progenitor (ETP)/near-ETP versus non-ETP immunophenotypes in T-ALL.
• To assess the correlation of ETP status with MRD levels at different time points and 1-year event-free survival (EFS-1).

Main Methods:

• Retrospective observational study analyzing bone marrow samples from newly diagnosed T-ALL patients.
• Evaluation of baseline hematologic characteristics and MRD levels at post-induction (Day-35) and post-consolidation (Day-78).
• Comparison of ETP/near-ETP and non-ETP subgroups regarding MRD positivity, clinical features, and survival outcomes.

Main Results:

• ETP/near-ETP immunophenotype was observed in 25.7% of patients (14.3% ETP-ALL, 11.4% near-ETP ALL).
• ETP/near-ETP patients showed a significantly higher risk of MRD positivity (>0.01%) post-induction compared to non-ETP patients (p=0.033).
• A trend towards increased anemia and induction failure was noted in ETP/near-ETP patients, though not statistically significant.

Conclusions:

• ETP status is associated with higher MRD positivity (>0.01%) after induction therapy in T-ALL.
• Despite post-induction MRD differences, ETP status did not significantly affect long-term event-free survival (EFS-1) in this cohort.
• Further research is needed to fully elucidate the prognostic role of ETP in T-ALL management.