Minimal residual disease assessment in childhood acute lymphoblastic leukaemia: a Swedish multi-centre study comparing real-time polymerase chain reaction and multicolour flow cytometry

作者：Thorn Ingrid^*; Forestier Erik; Botling Johan; Thuresson Britt; Wasslavik Carina; Bjorklund Elisabet; Li Aihong; Lindstrom Eriksson Eleonor; Malec Maria; Gronlund Elisabeth; Torikka Kerstin; Heldrup Jesper; Abrahamsson Jonas; Behrendtz Mikael; Soderhall Stefan; Jacobsson Stefan; Olofsson Tor; Porwit Anna; Lonnerholm Gudmar; Rosenquist Richard; Sundstrom Christer

来源：British Journal of Haematology, 2011, 152(6): 743-753.

DOI：10.1111/j.1365-2141.2010.08456.x

• flow cytometry
• RQ-PCR
• rearranged IG
• TCR genes
• minimal residual disease
• childhood acute lymphoblastic leukaemia

P>Minimal residual disease (MRD) assessment is a powerful prognostic factor for determining the risk of relapse in childhood acute lymphoblastic leukaemia (ALL). In this Swedish multi-centre study of childhood ALL diagnosed between 2002 and 2006, the MRD levels were analysed in 726 follow-up samples in 228 children using real-time quantitative polymerase chain reaction (RQ-PCR) of rearranged immunoglobulin/T-cell receptor genes and multicolour flow cytometry (FCM). Using an MRD threshold of 0 center dot 1%, which was the sensitivity level reached in all analyses, the concordance between RQ-PCR and FCM MRD values at day 29 was 84%. In B-cell precursor ALL, an MRD level of >= 0 center dot 1% at day 29 predicted a higher risk of bone marrow relapse (BMR) with both methods, although FCM was a better discriminator. However, considering the higher median MRD values achieved with RQ-PCR, a higher MRD cut-off (>= 0 center dot 2%) improved the predictive capacity of RQ-PCR. In T-ALL, RQ-PCR was notably superior to FCM in predicting risk of BMR. That notwithstanding, MRD levels of >= 0 center dot 1%, detected by either method at day 29, could not predict isolated extramedullary relapse. In conclusion, the concordance between RQ-PCR and FCM was high and hence both methods are valuable clinical tools for identifying childhood ALL cases with increased risk of BMR.

• 出版日期2011-3