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Clinical significance of minimal residual disease in adult acute lymphoblastic leukemia.

Authors
  • Kikuchi, Misato1
  • Tanaka, Junji
  • Kondo, Takeshi
  • Hashino, Satoshi
  • Kasai, Masaharu
  • Kurosawa, Mitsutoshi
  • Iwasaki, Hiroshi
  • Morioka, Masanobu
  • Kawamura, Tsugumichi
  • Masauzi, Nobuo
  • Fukuhara, Takashi
  • Kakinoki, Yasutaka
  • Kobayashi, Hajime
  • Noto, Satoshi
  • Asaka, Masahiro
  • Imamura, Masahiro
  • 1 Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, 060-8648, Japan. , (Japan)
Type
Published Article
Journal
International Journal of Hematology
Publisher
Springer-Verlag
Publication Date
Oct 01, 2010
Volume
92
Issue
3
Pages
481–489
Identifiers
DOI: 10.1007/s12185-010-0670-1
PMID: 20830615
Source
Medline
License
Unknown

Abstract

Monitoring minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL) is a useful way for assessing treatment response and relapse. We studied the value of MRD and showed a correlation with relapse for 34 adult patients with ALL. MRD was evaluated by real-time quantitative polymerase chain reaction (RQ-PCR) with probes derived from fusion chimeric genes (BCR/ABL) (n = 12) or PCR-based detection of clonal immunoglobulin and T cell receptor gene rearrangements (n = 16), or both (n = 6). We analyzed 27 of the 34 patients who could be examined for MRD on day 100 after induction therapy. The overall survival (OS) rate (45.0%) and relapse-free survival (RFS) rate (40.0%) at 2 years in complete remission (CR) patients with MRD level ≥ 10⁻³ (n = 12) were significantly lower than those in CR patients with MRD level <10(-3) (n = 15) (OS rate 79.0%, RFS rate 79.4%) (log-rank test, P = 0.017 and 0.0007). We also applied multicolor flow cytometry for comparison with MRD results analyzed by PCR methods. The comparison of results obtained in 27 follow-up samples showed consistency in 17 samples (63.0%) (P = 0.057). MRD analysis on day 100 is important for treatment decision in adult ALL.

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