title: Clinical significance of minimal residual disease in adult acute lymphoblastic leukemia.
abstract: Monitoring minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL) is a useful way for assessing treatment response and relapse. We studied the value of MRD and showed a correlation with relapse for 34 adult patients with ALL. MRD was evaluated by real-time quantitative polymerase chain reaction (RQ-PCR) with probes derived from fusion chimeric genes (BCR/ABL) (n = 12) or PCR-based detection of clonal immunoglobulin and T cell receptor gene rearrangements (n = 16), or both (n = 6). We analyzed 27 of the 34 patients who could be examined for MRD on day 100 after induction therapy. The overall survival (OS) rate (45.0%) and relapse-free survival (RFS) rate (40.0%) at 2 years in complete remission (CR) patients with MRD level ≥ 10⁻³ (n = 12) were significantly lower than those in CR patients with MRD level <10(-3) (n = 15) (OS rate 79.0%, RFS rate 79.4%) (log-rank test, P = 0.017 and 0.0007). We also applied multicolor flow cytometry for comparison with MRD results analyzed by PCR methods. The comparison of results obtained in 27 follow-up samples showed consistency in 17 samples (63.0%) (P = 0.057). MRD analysis on day 100 is important for treatment decision in adult ALL.
authors.affiliation: Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, 060-8648, Japan.
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Junji
authors.initials: J
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hashino
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kasai
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kurosawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Masanobu
authors.initials: M
authors.lastname: Morioka
authors.forename: Tsugumichi
authors.initials: T
authors.lastname: Kawamura
authors.forename: Nobuo
authors.initials: N
authors.lastname: Masauzi
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kakinoki
authors.forename: Hajime
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Noto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Imamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D016133:Polymerase Chain Reaction; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000517:prevention & control* / Q000601:surgery / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014184:Transplantation, Homologous; D055815:Young Adult