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Undetectable minimal residual disease is an independent prognostic factor in splenic marginal zone lymphoma
Author(s) -
Lyu Rui,
Wang Tingyu,
Wang Yi,
Xiong Wenjie,
Wang Huijun,
Yan Yuting,
Wang Qi,
Liu Wei,
An Gang,
Huang Wenyang,
Sui Weiwei,
Xu Yan,
Zou Dehui,
Wang Jianxiang,
Qiu Lugui,
Yi Shuhua
Publication year - 2021
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.17703
Subject(s) - medicine , splenic marginal zone lymphoma , hazard ratio , gastroenterology , minimal residual disease , rituximab , confidence interval , lymphoma , multivariate analysis , bone marrow , oncology , spleen , splenectomy
Summary The role of minimal residual disease (MRD) in splenic marginal zone lymphoma (SMZL) has not been well studied. We prospectively designed a study to evaluate undetectable MRD (uMRD) by multiparameter flow cytometry as a prognostic factor. Residual disease level of <0·01% was defined as uMRD. A total of 71 newly diagnosed patients with bone marrow involvement were enrolled and all received rituximab‐based therapy. The overall response rate (ORR) was 98·5% (70/71), with a complete remission (CR) rate of 54·9% (39/71). There were a total of 295 MRD detections in bone marrow and 77·4% patients (55/71) had uMRD. The 5‐year progression‐free survival (PFS) [(74·8 ± 6·5)% vs. (31·4 ± 12·6)%, P < 0·001] and 5‐year overall survival (OS) [(87·2 ± 5·6)% vs. (68·9 ± 13·4)%, P = 0·035] were significantly higher in uMRD patients than in MRD‐positive patients. The 5‐year PFS in partial remission (PR) patients with positive MRD was significantly poorer than that of PR patients with uMRD [(21·1 ± 12·9)% vs. (83·3 ± 8·8)%, P = 0·005]. Multivariate prognostic analysis revealed that uMRD was an independent good prognostic factor for PFS (hazard ratio 0·162, 95% confidence interval 0·041–0·635; P = 0·009). All these results highlight uMRD as an independent prognostic factor in patients with SMZL, especially for patients who only achieve PR.