Современная онкология (Mar 2018)
Clinical significance of the achievement of MRD-negativity in patients with chronic lymphocytic leukemia
Abstract
The determination of the minimal residual disease (MRD) in chronic lymphocytic leukemia (CLL) has acquired significance in connection with the success of therapy for this disease. Immunochemotherapy regimens significantly prolonged the life of CLL patients, which was associated with the achievement of MRD-negative remissions. MRD-status has been regarded as a predictor of progression-free survival and an endpoint in clinical studies. The use of new drugs - targeted BCR-signal inhibitors, bcl-2 inhibitors, new monoclonal antibodies and their combinations opened new perspectives for prognostically unfavorable CLL cases. The importance of MRD-negativity in the era of new drugs has become the object of modern research. There were also developing methods for determining MRD in CLL. This article presents data on the effect of MRD-negativity on the survival rates of patients at the current level of the development of therapy, as well as the prospects for the clinical use of the MRD status in the practice of patient management. Furthermore, we present results of an exploratory MRD analysis of a prospective BEN-001 study in Russia (bendamustine-rituximab in the first-line treatment of CLL). MRD status was evaluated in 84 pts. Bone marrow samples were available and evaluated in 81 (96.4%) pts. MRD-negative status after 6 courses of treatment was achieved in 27.4%. Our results in a sample of Russian patients are well aligned with MRD negativity rates from literature.
