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

We 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.

Automated summary

We measured minimal residual disease (MRD) by multiparameter flow cytometry at three time points in infants with KMT2A-rearranged and KMT2A-germline acute lymphoblastic leukemia. MRD was a strong independent outcome predictor in KMT2A-rearranged infant ALL, but not in KMT2A-germline infant ALL.