[The value of minimal residual disease and IKZF1 deletion for predicting prognosis in adult patients with B-cell acute lymphoblastic leukemia]

S Y Deng ¹, J W Ou ¹, Z C Huang ¹

⁰Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi +

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May 8, 2024

View abstract on PubMed

Summary

Minimal residual disease (MRD) and IKZF1 gene deletions are key prognostic factors in adult B-cell acute lymphoblastic leukemia (B-ALL). Combining MRD and IKZF1 status improves risk stratification and guides treatment decisions for better patient outcomes.

Area Of Science

Hematology
Oncology
Molecular Biology

Context

Adult B-cell acute lymphoblastic leukemia (B-ALL) presents unique challenges in treatment and prognosis.
Pediatric-specific chemotherapy regimens are increasingly used in adult B-ALL, necessitating reassessment of prognostic markers.
Minimal residual disease (MRD) and IKZF1 gene status are potential indicators of treatment response and patient outcomes.

Purpose

To evaluate the prognostic significance of MRD and IKZF1 gene deletions in adult B-ALL patients treated with pediatric-specific chemotherapy.
To identify reliable biomarkers for risk stratification and treatment guidance in this patient population.

Summary

A retrospective analysis of 149 adult B-ALL patients revealed that MRD positivity at day 45 (MRD(3)) independently predicts relapse risk (HR=2.535, P=0.025).
IKZF1 gene deletion was independently associated with increased mortality risk (HR=1.869, P=0.039).
A combined risk stratification based on MRD(3) and IKZF1 status significantly differentiated between high-risk and low-risk groups, impacting overall survival (OS) and cumulative incidence of relapse (CIR).

Impact

The combined assessment of MRD and IKZF1 gene status offers improved prognostic stratification for adult B-ALL patients.
This approach can aid clinicians in tailoring treatment strategies, potentially improving clinical outcomes.
The findings support the integration of these biomarkers into routine clinical practice for better management of adult B-ALL.

Keywords:

Gene, IKZF1 Leukemia, B-cell, acute Minimal residual disease Pediatric-inspired regimen therapy