[THE COMPARISON OF RESULTS OF DETECTION OF MINIMAL RESIDUAL DISEASE IN PERIPHERAL BLOOD AND MARROW IN CHILDREN OF THE
Insights
Monitoring minimal residual disease in infants with acute lymphoblastic leukemia is crucial. Bone marrow analysis is more reliable than peripheral blood for prognosis, as residual disease in bone marrow indicates a poor outcome.
Area of Science:
- Pediatric Hematology
- Oncology
- Molecular Diagnostics
Background:
- Minimal residual disease (MRD) is a key prognostic indicator in acute lymphoblastic leukemia (ALL).
- Bone marrow analysis is the standard for MRD detection in ALL research.
- The prognostic value of MRD in peripheral blood versus bone marrow requires further investigation, particularly in infant ALL.
Purpose of the Study:
- To compare the detection of MRD in peripheral blood and bone marrow in infants with ALL.
- To evaluate the prognostic role of MRD in peripheral blood and bone marrow during MLL-Baby protocol therapy.
Main Methods:
- Analysis of 142 paired samples from 53 infant ALL patients (<365 days) with MLL gene rearrangements.
- Real-time quantitative polymerase chain reaction (PCR) for chimeric transcript detection at 7 time points.
- Comparative analysis of MRD detection in peripheral blood and bone marrow samples.
Main Results:
- High comparability (84.5%) between peripheral blood and bone marrow MRD detection.
- MRD detected exclusively in bone marrow in 15.5% of discordant samples.
- MRD in peripheral blood lacked independent prognostic significance, unlike bone marrow MRD.
Conclusions:
- Peripheral blood is inappropriate for monitoring MRD in infant ALL due to lower sensitivity.
- Persistent MRD in bone marrow (TH4) is an independent unfavorable prognostic factor in infant ALL treated with the MLL-Baby protocol.
Abstract:
The occurrence of minimal residual disease is an important prognostic factor under acute lymphoblastic leucosis in children and adults. In overwhelming majority of research studies bone marrow is used to detect minimal residual disease. The comparative characteristic of detection of minimal residual disease in peripheral blood and bone marrow was carried out. The prognostic role of occurrence of minimal residual disease in peripheral blood and bone marrow under therapy according protocol MLL-Baby was evaluated. The analysis embraced 142 pair samples from 53 patients with acute lymphoblastic leucosis and various displacements of gene MLL younger than 365 days. The minimal residual disease was detected by force of identification of chimeric transcripts using polymerase chain reaction in real-time mode in 7 sequential points of observation established by protocol of therapy. The comparability of results of qualitative detection of minimal residual disease in bone marrow and peripheral blood amounted to 84.5%. At that, in all 22 (15.5%) discordant samples minimal residual disease was detected only in bone marrow. Despite of high level of comparability of results of detection of minimal residual disease in peripheral blood and bone marrow the occurrence of minimal residual disease in peripheral blood at various stages of therapy demonstrated no independent prognostic significance. The established differences had no relationship with sensitivity of method determined by value of absolute expression of gene ABL. Most likely, these differences reflected real distribution of tumor cells. The results of study demonstrated that application of peripheral blood instead of bone marrow for monitoring of minimal residual disease under acute lymphoblastic leucosis in children of first year of life is inappropriate. At the same time, retention of minimal residual disease in TH4 in bone marrow was an independent and prognostic unfavorable factor under therapy of acute lymphoblastic leucosis of children of first year of life according protocol MLL-Baby (OO=7.326, confidence interval 2.378-22.565).
More Related Videos
11:59Detection of Residual Donor Erythroid Progenitor Cells after Hematopoietic Stem Cell Transplantation for Patients with Hemoglobinopathies
Published on: September 6, 2017
09:01Flow Cytometry to Estimate Leukemia Stem Cells in Primary Acute Myeloid Leukemia and in Patient-derived-xenografts, at Diagnosis and Follow Up
Published on: March 26, 2018
