Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse
| Autor: | Michael L. Hancock, Dario Campana, Jeffrey E. Rubnitz, Nobuko Hijiya, John T. Sandlund, E. Coustan-Smith, Gaston K. Rivera, M. Andreansky, Amar J. Gajjar, Bassem I. Razzouk, Ching-Hon Pui, Raul C. Ribeiro |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Oncology Cancer Research medicine.medical_specialty Neoplasm Residual medicine.medical_treatment Bone Marrow hemic and lymphatic diseases Internal medicine Acute lymphocytic leukemia Antineoplastic Combined Chemotherapy Protocols medicine Humans Cumulative incidence Prospective Studies Child Prospective cohort study Childhood Acute Lymphoblastic Leukemia Chemotherapy Acute leukemia Hematology business.industry Remission Induction Infant Precursor Cell Lymphoblastic Leukemia-Lymphoma Prognosis medicine.disease Minimal residual disease Surgery body regions Child Preschool Female Neoplasm Recurrence Local business |
| Zdroj: | Leukemia. 18:499-504 |
| ISSN: | 1476-5551 0887-6924 |
| DOI: | 10.1038/sj.leu.2403283 |
| Popis: | Using flow cytometric techniques capable of detecting 0.01% leukemic cells, we prospectively studied minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL) after first relapse. At the end of remission reinduction, 41 patients had a bone marrow sample adequate for MRD studies; 35 of these were in morphologic remission. Of the 35 patients, 19 (54%) had MRD >/=0.01%, a finding that was associated with subsequent leukemia relapse. The 2-year cumulative incidence of second leukemia relapse was 70.2+/-12.3% for the 19 MRD-positive patients and 27.9+/-12.4% for the 16 MRD-negative patients (P=0.008). Among patients with a first relapse off therapy, 2-year second relapse rates were 49.1+/-17.8% in the 12 MRD-positive and 0% in the 11 MRD-negative patients (P=0.014); among those who received only chemotherapy after first relapse, the 2-year second relapse rates were 81.5+/-14.4% (n=12) and 25.0+/-13.1% (n=13), respectively (P=0.004). Time of first relapse and MRD were the only two significant predictors of outcome in a multivariate analysis. We conclude that MRD assays should be used to guide the selection of postremission therapy in patients with ALL in first relapse. |
| Databáze: | OpenAIRE |
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