Prognostic value of both detection of lymphoblasts in the period of early treatment and minimal residual disease in childhood acute lymphoblastic leukemia.
- Author:
Li-jun TIE
1
;
Long-jun GU
;
De-lian SONG
;
Li-min JIANG
;
Hui-liang XUE
;
Jing-yan TANG
;
Lu DONG
;
Ci PAN
;
Jing CHEN
;
Hui YE
;
Yao-ping WANG
;
Jing CHEN
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Bone Marrow; drug effects; pathology; Bone Marrow Examination; Child; Child, Preschool; Female; Humans; Infant; Male; Neoplasm, Residual; diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma; blood; drug therapy; pathology; Prognosis; Remission Induction; Survival Analysis
- From: Chinese Journal of Hematology 2005;26(1):6-9
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo assess the prognostic value of both morphological persistent disease on day 19, on complete remission (CR) and minimal residual disease (MRD) in the bone marrow (BM) after multiagent remission induction therapy.
METHODSFrom January 1998 to May 2003, 193 patients with newly diagnosed ALL were enrolled on protocol of ALL-XH-99. BM blast counts on day 19 and on CR after induction therapy were examined. BM MRD at the end of induction therapy was detected by MP-FCM.
RESULTS(1) The probability of 5-year event-free survival (pEFS) was significantly worse for patients with > or = 0.050 BM lymphoblasts on day 19 than that with < 0.050 BM lymphoblasts [(42.59 +/- 14.28)% vs (74.24 +/- 6.67)%, P < 0.001]. (2) The 5-year pEFS was significantly worse for patients with a low percentage of lymphoblasts (< 0.050) in BM on CR as compared to those with no morphological persistent lymphoblasts [(63.47 +/- 9.23)% vs (76.41 +/- 6.09)%, P < 0.05]. (3) No significant difference was found in BM lymphoblasts between patients with MRD (> or = 10(-4) of nucleated bone marrow cells) and those without MRD (< 10(-4)) at the end of induction therapy (P > 0.05). The 22-month pEFS was significantly worse for patients with MRD as compared with those without MRD on CR [(23.81 +/- 20.26)% vs (94.44 +/- 5.40)%, P = 0.001].
CONCLUSIONSBM lymphoblast > or = 0.050 on day 19 after induction therapy is an independent prognostic factor for childhood ALL; low percentage of lymphoblasts and minimal residual disease in BM on remission also do it. Patients with > or = 0.050 lymphoblast in BM on day 19 or with MRD > or = 10(-4) at the end of induction therapy should receive altered and more intensive chemotherapy.
