Significance of four MRD markers in MRD-based treatment strategy for childhood acute lymphoblastic leukemia.
Newly diagnosed children with ALL (n=32) were treated on a protocol incorporating minimal residual disease (MRD)-based treatment decisions. MRD was monitored at 4 time points by semi-quantitative PCR detection of antigen receptor gene rearrangement, flow cytometry, quantitative RT-PCR detection of chimeric gene transcripts and overexpressed WT1 mRNA. Four patients positive for MRD at week 5 were treated with an intensified regimen. Median follow-up was 5.0 years (range 3.8-6.6 years) with a 4-year event-free survival rate of 93.8+/-4.3%. This MRD-based treatment strategy seems to be highly successful and may improve the outcomes of children with ALL. A large study is warranted.
Sawada
Akihisa
A
Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo, Izumi City, Osaka 594-1101, Japan. asawada@mch.pref.osaka.jp
Sakata
Naoki
N
Kishimoto
Tomoko
T
Higuchi
Banryoku
B
Koyama
Maho
M
Kondo
Osamu
O
Sato
Emiko
E
Okamura
Takayuki
T
Yasui
Masahiro
M
Inoue
Masami
M
Yoshioka
Akira
A
Kawa
Keisei
K
D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000188:drug therapy / Q000628:therapy; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor