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Shumilov et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract11
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Minimal residual disease evaluation in patients with acute lymphoblastic leukemia

Evgeniy G. Shumilov, Alexandra A. Sipol, Elena V. Babenko, Elena V. Semenova, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Pavlov State Medical University, Saint-Petersburg, Russia

Correspondence: Alexandra A. Sipol, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint-Petersburg Pavlov State Medical University, 6/8, Tolstoy str., Saint-Petersburg, 197022, Russia, E-mail: transimmun@spam is badmail.ru 

Abstract

Minimal residual disease (MRD) is the persistence of a low number of leukemic cells in patients who achieve clinical and hematological remission.

The aim of this study was to define the prognostic value of MRD detection by flow cytometry.  

Materials and methods: We analyzed 145 bone marrow samples from 41 patients with multiparametry flow cytometry. 21 patients (children and young adults) had newly diagnosed B-precursors leukemia, treated with the chemotherapy protocol “Moscow-Berlin 2008”, and 20 patients had undergone allogeneic hematopoietic stem cell transplantation (alloHSCT). The following monoclonal antibody combinations were used: CD10/CD34/CD19/CD20, CD22/CD34/CD19/CD45, CD38/CD34/CD19/CD45. To verify their MRD-status we compared the flow cytometry data with molecular biology, cytogenetic, and morphology assays.

Results: At the end of first consolidation therapy we observed a positive MRD in 4 patients (19%); three of them also had a positive MRD after the second consolidation, which then became negative.  
  
Four patients (19%) had a positive MRD status after the second consolidation. All patients were in remission at the time of the study (median of observation 11 months). In 10 patients (50%) post-alloHSCT the MRD was negative, which corresponded to the molecular biology data. Three patients had one positive MRD, they also stayed in remission. Four patients (20%) had MRD-positive status on every time-point of observation. Three of them developed relapse. Overall 4-year survival was significantly higher (p=0.014) in patients with a negative MRD status on every time-point.  
 
Conclusion: Measurement of MRD by multiparametry flow cytometry, based on leukemia-associated immunophenotype, provides prognostic information in children with ALL.

Keywords: allogeneic hematopoietic stem cell transplantation, acute lymphoblastic leukemia, minimal residual disease, flow cytometry

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