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Minimal residual disease in cerebrospinal fluid at diagnosis: a more intensive treatment protocol was able to eliminate the adverse prognosis in children with acute lymphoblastic leukemia.

Authors
  • Biojone, Estefânia
  • Queiróz, Rosane De Paula
  • Valera, Elvis Terci
  • Odashima, Newton Satoro
  • Takayanagui, Osvaldo Massaiti
  • Viana, Marcos Borato
  • Tone, Luiz Gonzaga
  • Scrideli, Carlos Alberto
Type
Published Article
Journal
Leukemia & Lymphoma
Publisher
Informa UK (Taylor & Francis)
Publication Date
Jan 01, 2012
Volume
53
Issue
1
Pages
89–95
Identifiers
DOI: 10.3109/10428194.2011.606939
PMID: 21774746
Source
Medline
License
Unknown

Abstract

We analyzed cerebrospinal fluid (CSF) samples from 65 consecutive children with acute lymphoblastic leukemia (ALL) treated according to two different treatment protocols (GBTLI-ALL-93 and -99) with no puncture accident for minimal residual disease (MRD) in the central nervous system (CNS). Minimal residual disease was detected by polymerase chain reaction (PCR) with homo/heteroduplex analysis using consensus primers to IgH and TCR genes. MRD in the CSF at diagnosis was detected by PCR in 46.8% of children with no puncture accident or morphological involvement. In patients treated with GBTLI-ALL-93 a significantly lower 5-year event-free survival (EFS) was demonstrated for those with CSF involvement, in univariate (p = 0.01) and multivariate (p = 0.04) analysis. This observation was not true for patients treated with the more intensive protocol GBTLI-ALL-99 (p = 0.81). These findings suggest that MRD detection in the CSF is a common event in children with ALL. Treatment intensification provided by the GBTLI-ALL-99 apparently overcomes the detrimental effect of CNS minimal residual disease at diagnosis.

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