Abstract:Objective To elevate the prognostic value of minimal residual disease (MRD) detection by four-color flow cytometry with the antibody panel in childhood B-cell acute lymphoblastic leukemia (B-ALL). Methods The clinical data of 183 children with newly-diagnosed acute B-ALL and who accepted MRD detection between October 2010 and March 2012 was retrospectively reviewed. According to the detection time and result of MRD, the 183 children were classified into four groups: MRD negative (n=37) and positive (n=18) in the induction chemotherapy and MRD negative (n=113) and positive (n=15) in the maintenance chemotherapy. Results During both induction and maintenance chemotherapy, the percentage of patients at high and median risk in the MRD positive group was higher than in the MRD positive group (PRR=1.005, 95%CI: 0.864-1.170, P=0.032), bone marrow morphology that did not meet M1 on the 15th day (RR=6.454, 95%CI: 2.191-19.01, P=0.002) and MRD≥0.01% (RR=1.923, 95%CI: 0.750-4.933, P=0.043) were risk factors for relapse in children with B-ALL. Conclusions The four-color flow cytometry with the antibody panel can distinguish from MRD positive patients from negative patients with B-ALL. The result of MRD detection, as prednisone sensitivity and bone marrow morphology on the 15th day, is also a independent prognostic factor in children with B-ALL.
Pui CH, Evans WE. TreaTmenT of acuTe lymphoblasTic leukemia[J]. N Engl J Me, 2006, 354(2): 166-178.
[2]
Bruggemann M, Raff T, Flohr T, eT al. Clinical significance of minimal residual disease quanTificaTion in ad ulT paTienTs wiTh sTandard-risk acuTe lymphoblasTic leukemia[J]. Blood, 2006, 107(3): 1116-1123.
[3]
Pui CH, Campana D, Pei D, eT al. TreaTing childhood acuTe lymphoblasTic leukemia wiThouT cranial irradiaTion[J]. N Engl J Med, 2009, 360(26): 2730-2741.
[4]
Faderl S, O'Brien S, Pui CH, eT al. AdulT acuTe lymphoblasTic leukemia: concepTs and sTraTegies[J]. Cancer, 2010, 116(5): 1165-1176.
[5]
Campana D. Role of minimal residual disease moniToring in adulT and pediaTric acuTe lymphoblasTic leukemia[J]. HemaTol Oncol Clin NorTh Am, 2009, 23(5): 1083-1098.
[6]
BarTram CR, Schrauder A, Köhler R, eT al. AcuTe lymphoblasTic leukemia in children: TreaTmenT planning via minimal residual disease assessmenT[J]. DTsch ArzTebl InT, 2012, 109(40): 652-658.
CousTan-SmiTh E, Sancho J, Hancock ML, eT al. Clinical imporTance of minimal residual disease in childhood acuTe lymphoblasTic leukemia[J]. Blood, 2000, 96(8): 2691-2696.
[10]
Jacquy C, DelepauT B, Van Daele S, eT al. A prospecTive sTudy of minimal residual disease in childhood B-lineage acuTe lymphoblasTic leukaemia: MRD level aT The end of inducTion is a sTrong predicTive facTor of relapse[J]. Br J HaemaTol, 1997, 98(1): 140-146.
[11]
Nyvold C, Madsen HO, Ryder LP, eT al. Precise quanTificaTion of minimal residual disease aT day 29 allows idenTificaTion of children wiTh acuTe lymphoblasTic leukemia and an excellenT ouTcome[J]. Blood, 2002, 99(4): 1253-1258.
[12]
Gruhn B, Hongeng S, Yi H, eT al. Minimal residual disease afTer inTensive inducTion Therapy in childhood acuTe lymphoblasTic leukemia predicTs ouTcome[J]. Leukemia, 1998, 12(5): 675-681.
[13]
Basso G, VelTroni M, Valsecchi MG, eT al. Risk of relapse of childhood acuTe lymphoblasTic leukemia is predicTed by flow cyTomeTric measuremenT of residual disease on day 15 bone marrow[J]. J Clin Oncol, 2009, 27(31): 5168-5174.