title: Gene rearrangement study for minimal residual disease monitoring in children with acute lymphocytic leukemia.
abstract: OBJECTIVE
  To detect markers for minimal residual disease monitoring based on conventional polymerase chain reaction for immunoglobulin, T-cell receptor rearrangements and the Sil-Tal1 deletion in patients with acute lymphocytic leukemia.
  
  
  METHODS
  Fifty-nine children with acute lymphocytic leukemia from three institutions in Minas Gerais, Brazil, were prospectively studied. Clonal rearrangements were detected by polymerase chain reaction followed by homo/heteroduplex clonality analysis in DNA samples from diagnostic bone marrow. Follow-up samples were collected on Days 14 and 28-35 of the induction phase. The Kaplan-Meier and multivariate Cox methods were used for survival analysis.
  
  
  RESULTS
  Immunoglobulin/T-cell receptor rearrangements were not detected in 5/55 children screened (9.0%). For precursor-B acute lymphocytic leukemia, the most frequent rearrangement was IgH (72.7%), then TCRG (61.4%), and TCRD and IgK (47.7%); for T-acute lymphocytic leukemia, TCRG (80.0%), and TCRD and Sil-Tal deletion (20.0%) were the most common. Minimal residual disease was detected in 35% of the cases on Day 14 and in 22.5% on Day 28-35. Minimal residual disease on Day 28-35, T-acute lymphocytic leukemia, and leukocyte count above 50 x 10(9)/L at diagnosis were bad prognostic factors for leukemia-free survival in univariate analysis. Relapse risk for minimal residual disease positive relative to minimal residual disease negative children was 8.5 times higher (95% confidence interval: 1.02-70.7).
  
  
  CONCLUSIONS
  Immunoglobulin/T-cell receptor rearrangement frequencies were similar to those reported before. Minimal residual disease is an independent prognostic factor for leukemia-free survival, even when based on a non-quantitative technique, but longer follow-ups are needed.
authors.affiliation: Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brazil.
authors.forename: Juliana Godoy
authors.initials: JG
authors.lastname: Assumpção
authors.forename: Francisco Danilo Ferreira
authors.initials: FD
authors.lastname: Paula
authors.forename: Sandra Guerra
authors.initials: SG
authors.lastname: Xavier
authors.forename: Mitiko
authors.initials: M
authors.lastname: Murao
authors.forename: Joaquim Caetano
authors.initials: JC
authors.lastname: de Aguirre
authors.forename: Alvaro Pimenta
authors.initials: AP
authors.lastname: Dutra
authors.forename: Eduardo Ribeiro
authors.initials: ER
authors.lastname: Lima
authors.forename: Benigna Maria
authors.initials: BM
authors.lastname: de Oliveira
authors.forename: Marcos Borato
authors.initials: MB
authors.lastname: Viana
keywords: Gene rearrangement; Neoplasm, residual; Polymerase chain reaction; Precursor cell lymphoblastic leukemia-lymphoma