Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia
Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia
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DOI：
10.1056/nejm199808273390904
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发表时间：
1998-08-27
影响因子：
158.5
通讯作者：
Vilmer, E
中科院分区：
文献类型：
--
作者：
Cavé, H;ten Bosch, JV;Vilmer, E
背景和方法急性淋巴细胞白血病（ALL）治疗后残留疾病检测的意义尚不清楚。我们在11个中心进行了一项前瞻性研究，以确定在儿童ALL完全缓解后的前6个月内的几个时间点上存在或不存在可检测的残留疾病的预测价值。T细胞受体或免疫球蛋白基因重排的连接序列被用作白血病细胞的克隆标记。残留病变用竞争性聚合酶链反应（PCR）测定进行定量。在246名接受诊断并接受统一化疗方案治疗的患者中，178名患者接受了一种克隆特异性探针（74%）或一种以上探针（26%）的残留疾病监测。结果有无残留白血病及残留白血病的程度与早期复发的危险性显著相关（P
Background and Methods The implications of the detection of residual disease after treatment of acute lymphoblastic leukemia (ALL) are unclear. We conducted a prospective study at 11 centers to determine the predictive value of the presence or absence of detectable residual disease at several points in time during the first six months after complete remission of childhood ALL had been induced. Junctional sequences of T-cell-receptor or immunoglobulin gene rearrangements were used as clonal markers of leukemic cells. Residual disease was quantitated with a competitive polymerase-chain-reaction (PCR) assay. Of 246 patients enrolled at diagnosis and treated with a uniform chemotherapy protocol, 178 were monitored for residual disease with one clone-specific probe (in 74 percent) or more than one probe tin 26 percent). The median follow-up period was 38 months.Results The presence or absence and level of residual leukemia were significantly correlated with the risk of early relapse at each of the times studied (P