[Children with acute lymphoblastic leukemia: prognostic significance of polymerase-chain-reaction analysis of minimal residual disease].
OBJECTIVE
Determination of the usefulness of polymerase chain reaction (PCR) for the detection of minimal residual disease (MRD) in bone marrow in children suffering from progenitor-B cell acute lymphoblastic leukaemia during and after treatment.


METHODS
Descriptive.


METHODS
Emma's Children's Hospital, Academic Medical Centre, University of Amsterdam and Central Laboratory of the Dutch Red Cross, Amsterdam.


METHODS
Of 50 children suffering from progenitor-B cell ALL, stored bone marrow samples and bone marrow slides were investigated: 328 bone marrow samples were analysed by PCR for IgH/TCR delta; 34 patients were analysed at the end of induction therapy. Follow-up period was 20 to 133 months.


RESULTS
Twenty-two patients stayed in continuous complete remission (CCR), 28 patients experienced a recurrence (REC). Reduction of tumour mass was higher in the CCR group. At the end of induction therapy 2/18 CCR patients and 10/16 REC patients were PCR positive (p = 0.005). PCR positivity was not related with known prognostic factors. After recurrence 6/8 patients, who became PCR negative, stayed in remission. All patients who stayed positive after treatment for their recurrence died from leukaemia (p = 0.006). All children who were only temporary PCR negative suffered a recurrence.


CONCLUSIONS
Analysis of MRD by means of PCR on bone marrow samples during and after treatment for progenitor-B cell ALL is of prognostic importance.
Steenbergen
E J
EJ
Centraal Laboratorium van de Bloedtransfusiedienst, Amsterdam.
Verhagen
O J
OJ
van den Berg
H
H
van Leeuwen
E F
EF
von dem Borne
A E
AE
van der Schoot
C E
CE
D014408:Biomarkers, Tumor / Q000235:genetics; D001854:Bone Marrow Cells; D002648:Child; D006801:Humans; D018365:Neoplasm, Residual / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000276:immunology; D011379:Prognosis; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics; D012008:Recurrence
D014408:Biomarkers, Tumor; D016692:Receptors, Antigen, T-Cell, gamma-delta
Kinderen met acute lymfoblastenleukemie: de prognostische betekenis van analyse door middel van de polymerase-kettingreactie van minimale residuale ziekte.