Clinical, Economic Outcomes of B-Cell Precursor Acute Lymphocytic Leukemia

B-cell precursor acute lymphocytic leukemia (ALL) presents a significant clinical and economic burden, according to a retrospective medical chart review.

Researchers gathered patient-level data in 2018 on adults with at least one minimal residual disease (MRD) test during front-line ALL treatment. A total of 82 patients (median age, 44 years) were included in the study. About one-quarter of patients (23%) were Philadelphia chromosome-positive; 17 patients were MRD-positive, 50 were MRD-negative, and MRD results were unknown in 15 patients. The most commonly used front-line treatment protocols were HyperCVAD (32%) and HOVON (26%), while 22% received hematopoietic cell transplantation. About three-quarters of patients with ALL (76%) were hospitalized. Sixty-six patients (80%) achieved complete hematological response (CRh); median relapse-free survival from CRh was 32.7 months: 11.7 months for MRD-positive patients and 33.3 months for MRD-negative patients. Median overall survival was 28.9 months.

“B-cell precursor ALL represents a clinical burden and impacts healthcare resources; MRD-positive patients have worse prognosis than MRD-negative patients. Efforts should be made to adhere to recommendations for MRD testing in clinical guidelines,” the authors concluded.