Use of peripheral blood instead of bone marrow to monitor residual disease in children with acute lymphoblastic leukemia
Use of peripheral blood instead of bone marrow to monitor residual disease in children with acute lymphoblastic leukemia
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DOI：
10.1182/blood-2002-04-1130
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发表时间：
2002-10-01
期刊：
影响因子：
20.3
通讯作者：
Campana, D
中科院分区：
文献类型：
--
作者：
Coustan-Smith, E;Sancho, J;Campana, D
在患有急性淋巴细胞白血病（所有）的儿童中，通过骨髓抽吸评估对治疗的反应。我们研究了最小残留疾病（MRD）是否可以在外周血中有效监测。我们使用了能够检测1000或更多正常细胞中1个白血病细胞的流式细胞仪技术，以比较718对骨髓和外周血样本中的MRD测量，并在治疗期间从226名儿童中收集的周围血液样本进行了新诊断。在骨髓和血液中以72对和骨髓中的血液检测到MRD，但在67对中没有在血液中检测到MRD。在其余的579对中，它是无法检测的。值得注意的是，在T-Linege的150例配对样品中，骨髓和血液中的发现完全一致：对于35个阳性骨髓样品中的每一个，相应的血液样本都是阳性的。然而，在B-Linege中，只有104个正骨髓样品中只有37个具有相应的阳性血液样本。值得注意的是，这些患者的外周血MRD与疾病复发的高风险有关。 B-linege患者的4年累积复发发生率全部为80.0％+/- 24.9％，在缓解诱导疗法结束时患有外周血MRD的患者的复发率为24.9％局限于骨髓（p = .007）。这些结果表明，周围血液可用于监测全部T型的患者中的MRD，并且外周血MRD可能会在B-Linege的患者中提供强有力的预后信息。 （c）2002年美国血液学学会。
In children with acute lymphoblastic leukemia (ALL), response to treatment is assessed by bone marrow aspiration. We Investigated whether minimal residual disease (MRD) can be effectively monitored In peripheral blood. We used flow cytometric techniques capable of detecting 1 leukemic cell among 10 000 or more normal cells to compare MRD measurements In 718 pairs of bone marrow and peripheral blood samples collected from 226 children during treatment for newly diagnosed ALL. MRD was detected in marrow and blood in 72 pairs and in marrow but not in blood in 67 pairs; it was undetectable in the remaining 579 pairs. Remarkably, findings in marrow and blood were completely concordant in the 150 paired samples from patients with T-lineage ALL: for each of the 35 positive marrow samples, the corresponding blood sample was positive. In B-lineage ALL, however, only 37 of 104 positive marrow samples had a corresponding positive blood sample. Notably, peripheral blood MRD in these patients was associated with a very high risk for disease recurrence. The 4-year cumulative incidence of relapse in patients with B-lineage ALL was 80.0% +/- 24.9% for those who had peripheral blood MRD at the end of remission Induction therapy but only 13.3% +/- 9.1% for those with MRD confined to the marrow (P = .007). These results indicate that peripheral blood may be used to monitor MRD in patients with T-lineage ALL and that peripheral blood MRD may provide strong prognostic Information In patients with B-lineage ALL. (C) 2002 by The American Society of Hematology.