Summary
The prognostic value of minimal residual disease (MRD) measured by fusion‐gene transcript (FGT) detection was investigated in 76 infants (aged ≤1 year) with acute lymphoblastic leukaemia (ALL) with lysine methyltransferase 2A (KMT2A) rearrangements. Either at the end of induction or at later time‐points, FGT‐MRD‐positivity was associated with poor outcome. FGT‐MRD‐positivity after first consolidation or first high‐risk block detected 46·5% of infants with extremely poor outcome [disease‐free survival (SE) 0·06 (0·06), cumulative incidence of relapse (SE) 0·91 (0·05)], which was also confirmed in multivariable analysis. Thus, FGT‐MRD measurement at a single time‐point clearly identifies infants with ALL who are curable with conventional chemotherapy and those who would benefit only from other treatment approaches.
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