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Childhood Acute Lymphoblastic Leukemia: Detection of Minimal Residual Disease after Allogeneic Transplantation
Florina M. Boldeanu, Alexandra T. Gruia, Valentin L. Ordodi, Margit Serban, Peter Bader, Hermann Kreyenberg
Abstract: Most minimal residual disease-directed therapeutic interventions in current treatment protocols for acute lymphoblastic leukemia (ALL) are based on bone marrow and peripheral blood testing. In this study, we employed real-time quantitative polymerase chain reaction analysis (Real Time PCR) to examine minimal residual disease (MRD) in 28 patients (pts) with ALL, 36% receiving transplantation from related donors and 64% receiving transplantation from nonrelated donors. Determined MRD positivity ranged from positive below quantitative range (2 pts, 7.17%), between 0.01 % and 0.1 % (1 pts, 3.57%), and higher than 0.1 % (6 pts., 21.42%). Eight patients were MRD negative and during observation the MRD became positive. Two patients determined to be MRD positive (0.0001 %) in the early phase showed subsequent increase of MRD load, while another two, who were determined to be positive in the later phase did not. We had two patients with strong positive MRD in which during observation the MRD turned to negative due to clinical intervention. However, for 5 patients with high MRD load the induction of remission was not obtained. As a perspective, a well characterized and homogenous patient cohort should be enrolled in a clinical study to investigate the impact of post transplant MRD on the outcome.
Keywords: acute lymphoblastic leukemia,peripheral blood,bone marrow,minimal residual disease
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Boldeanu FM, Gruia AT, Ordodi VL, Serban M, Bader P, Kreyenberg H. Childhood Acute Lymphoblastic Leukemia: Detection of Minimal Residual Disease after Allogeneic Transplantation. Rev Romana Med Lab. 2012;20(3):245-53
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