title: Role of peripheral blood minimum residual disease at day 8 of induction therapy in high-risk pediatric patients with acute lymphocytic leukemia.
abstract: Risk stratification and treatment intensification, based on minimal residual disease (MRD) mensurement, changed the prognosis of pediatric patients with acute lymphocytic leukemia (ALL). The main aim of this study was to investigate whether peripheral blood (PB) MRD measurement at day 8 (D8) could predict the risk stratification category determined by bone marrow (BM) MRD at day 15 (D15). The study was performed prospectively, in a cohort of 40 children with B-lineage ALL, adopting the protocol of the Brazilian Cooperative Group of the Treatment Childhood Leukemia (GBTLI-2009). MRD was detected by flow cytometry (FC) using a simplifed panel that can reliably identify MRD at early phases of induction therapy. Upon diagnosis, the proportion of low and high-risk patients, was 24:16 (60%:40%). The main result of our study demonstrated the potential of D8 MRD in anticipating of week the risk stratification of high-risk patients as determined by D15 BM MRD. In these patients D8 MRD level of 1% was able to segregate high risk fast responders from high risk slow responders (p = 0.0097). This result could represent an opportunity for early treatment intensification, as already performed in some protocols.
authors.affiliation: Hematology and Hemotherapy Foundation of Amazonas (HEMOAM), Manaus, AM, Brazil.|Federal University of Amazonas (UFAM), Manaus, Amazonas, Brazil.
authors.forename: Thais Ditolvo da Costa
authors.initials: TD
authors.lastname: Salina
authors.affiliation: Hematology and Hemotherapy Foundation of Amazonas (HEMOAM), Manaus, AM, Brazil.
authors.forename: Yvelise Antunes
authors.initials: YA
authors.lastname: Ferreira
authors.affiliation: Hematology and Hemotherapy Foundation of Amazonas (HEMOAM), Manaus, AM, Brazil.|Federal University of Amazonas (UFAM), Manaus, Amazonas, Brazil.
authors.forename: Eliana Brasil
authors.initials: EB
authors.lastname: Alves
authors.affiliation: Hematology and Hemotherapy Foundation of Amazonas (HEMOAM), Manaus, AM, Brazil.
authors.forename: Cristina Motta
authors.initials: CM
authors.lastname: Ferreira
authors.affiliation: Hematology and Hemotherapy Foundation of Amazonas (HEMOAM), Manaus, AM, Brazil.|Hematology and Hemotherapy Center, University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: Erich Vinícius
authors.initials: EV
authors.lastname: De Paula
authors.affiliation: Hematology and Hemotherapy Foundation of Amazonas (HEMOAM), Manaus, AM, Brazil.|Pontifícia Universidade Católica do Paraná, Graduate Program in Health Sciences, Curitiba, Parana, Brazil.
authors.forename: Marcelo Távora
authors.initials: MT
authors.lastname: Mira
authors.affiliation: Hematology and Hemotherapy Foundation of Amazonas (HEMOAM), Manaus, AM, Brazil.
authors.forename: Leny da Mota
authors.initials: Lda M
authors.lastname: Passos
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D007223:Infant; D008297:Male; D018365:Neoplasm, Residual; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*