title: [Prognostic value of minimal residual disease in childhood B-cell acute lymphoblastic leukemia].
abstract: OBJECTIVE
  To assess the prognostic value of minimal residual disease (MRD) in childhood B-cell acute lymphoblastic leukemia (ALL) after induction chemotherapy.
  
  
  METHODS
  From September 2001 to October 2004, 102 patients with newly diagnosed B-ALL were enrolled in protocol ALL-XH-99. MRD after induction therapy, before high-dose methotrexate and early intensification as well as at 1 year and 2 year maintenance therapy was detected by multiparameter-flow-cytometry (MP-FCM).
  
  
  RESULTS
  (1) The probability of 39-month event-free survival (EFS) for patients with a level of MRD < 10(-4), was significantly higher than for those with a higher MRD [(83.00 +/- 9.90)% vs 0.00%, P < 0.01]. (2) Univariate analysis indicated that the MRD level at achieving complete remission (CR) had no relationship with the biologic features at presentation (gender, age, white blood cells and cytogenetic abnormalities), but did with Philadelphia chromosome, the time reaching CR, ALL-XH-99 risk group and lymphoblasts in bone marrow on day 19 after induction therapy (P < 0.05). (3) Multivariate analysis suggested that MRD level after the first induction course was an independent prognostic factor (hazard ratio, 5.381; 95% CI 0.004 to 0.624; P < 0.05).
  
  
  CONCLUSIONS
  The MRD level at achieving CR is one of important prognostic factor in the treatment of childhood B-cell ALL, and might be used to assess the early treatment response.
authors.affiliation: Department of Hematology/Oncology, the Affiliated Xinhua Hospital, Shanghai Children's Medical Center of Shanghai Jiaotong University, Shanghai 200127, China.
authors.forename: Li-jun
authors.initials: LJ
authors.lastname: Tie
authors.forename: Long-jun
authors.initials: LJ
authors.lastname: Gu
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Li-min
authors.initials: LM
authors.lastname: Jiang
authors.forename: Lu
authors.initials: L
authors.lastname: Dong
authors.forename: Ci
authors.initials: C
authors.lastname: Pan
authors.forename: Hui
authors.initials: H
authors.lastname: Ye
authors.forename: De-lian
authors.initials: DL
authors.lastname: Song
authors.forename: Hui-liang
authors.initials: HL
authors.lastname: Xue
authors.forename: Jing-yan
authors.initials: JY
authors.lastname: Tang
authors.forename: Yao-ping
authors.initials: YP
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015448:Leukemia, B-Cell / Q000188:drug therapy*; D008297:Male; D018365:Neoplasm, Residual / Q000175:diagnosis; D011379:Prognosis; D012074:Remission Induction