title: Combined analysis of morphology and fluorescence in situ hybridization in follow-up of minimal residual disease in a child with Philadelphia-positive acute lymphoblastic leukemia.
abstract: The past decade has brought new technologies to the study of minimal residual disease (MRD) in leukemia. Each of them has limitations and is far from being accurate. Recently, a new multiparametric cell scanning system (Duet) was introduced to the field of MRD detection. This system has the advantage of automatically scanning large numbers of cells and performing combined analysis of morphology and fluorescence in situ hybridization (FISH) on the same cell. We used this system to characterize the lineage and degree of maturation of the cells carrying the minor m-BCR/ABL fusion, in a follow-up of an 8-year-old boy with Philadelphia-positive (Ph(+)) acute lymphoblastic leukemia (ALL). The boy was treated using a high-risk protocol and was closely monitored with FISH analysis for cells carrying the m-BCR/ABL fusion. Consecutive analysis along 2.5 years from remission showed 0.2-4.5% m-BCR/ALB(+) cells in the peripheral blood (PB), which is within the accepted background range for this method. The combined analysis found that all the m-BCR/ABL(+) cells were mature lymphocytes. Because mature lymphocytes have a long life span in the circulation, this finding supports the fact that the patient is in remission. Moreover, since mature differentiated cells have a low proliferative capacity, there is a low risk for relapse.
authors.affiliation: Department of Pediatric Hemato-Oncology and Institute of Hematology, The Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, 5262, Tel-Aviv, Israel.
authors.forename: Bella
authors.initials: B
authors.lastname: Bielorai
authors.forename: Hana
authors.initials: H
authors.lastname: Golan
authors.forename: Luba
authors.initials: L
authors.lastname: Trakhtenbrot
authors.forename: Malka
authors.initials: M
authors.lastname: Reichart
authors.forename: Amos
authors.initials: A
authors.lastname: Toren
authors.forename: Michal
authors.initials: M
authors.lastname: Daniely
authors.forename: Yulia
authors.initials: Y
authors.lastname: Zilberstein
authors.forename: Ninette
authors.initials: N
authors.lastname: Amariglio
authors.forename: Gideon
authors.initials: G
authors.lastname: Rechavi
authors.forename: Chaim
authors.initials: C
authors.lastname: Kaplinsky
mesh_terms: D002455:Cell Division; D019070:Cell Lineage; D048429:Cell Size; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D016044:Fusion Proteins, bcr-abl / Q000032:analysis; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics* / Q000473:pathology*; D008297:Male; D018365:Neoplasm, Residual / Q000235:genetics* / Q000473:pathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000473:pathology*
chemical_list: D016044:Fusion Proteins, bcr-abl