Minimal residual disease predicts outcomes in KMT2A‐rearranged but not KMT2A‐germline infant acute lymphoblastic leukemia: Report from Children's Oncology Group study AALL0631

Abstract

AbstractWe measured minimal residual disease (MRD) by multiparameter flow cytometry at three time points (TP) in 117 infants with KMT2A (lysine [K]‐specific methyltransferase 2A)‐rearranged and 58 with KMT2A‐germline acute lymphoblastic leukemia (ALL) on Children's Oncology Group AALL0631 study. For KMT2A‐rearranged patients, 3‐year event‐free survival (EFS) by MRD‐positive (≥0.01%) versus MRD‐negative (<0.01%) was: TP1: 25% (±6%) versus 49% (±7%; p = .0009); TP2: 21% (±8%) versus 47% (±7%; p < .0001); and TP3: 22% (±14%) versus 51% (±6%; p = .0178). For KMT2A‐germline patients, 3‐year EFS was: TP1: 88% (±12%) versus 87% (±5%; p = .73); TP2: 100% versus 88% (±5%; p = .24); and TP3: 100% versus 87% (±5%; p = .53). MRD was a strong independent outcome predictor in KMT2A‐rearranged, but not KMT2A‐germline infant ALL.