Minimal residual disease monitoring cannot fully replace bone marrow morphology in assessing disease status in pediatric acute lymphoblastic leukemia.
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Bone Marrow
/ pathology
Child
Child, Preschool
Female
Flow Cytometry
Humans
Immunophenotyping
Male
Neoplasm Recurrence, Local
/ diagnosis
Neoplasm, Residual
/ diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ diagnosis
Remission Induction
Acute lymphoblastic leukemia
bone marrow morphology
minimal residual disease
pediatric
Journal
APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
ISSN: 1600-0463
Titre abrégé: APMIS
Pays: Denmark
ID NLM: 8803400
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
28
10
2019
accepted:
24
02
2019
pubmed:
29
2
2020
medline:
13
6
2020
entrez:
29
2
2020
Statut:
ppublish
Résumé
Minimal residual disease (MRD) monitoring has a strong prognostic value in childhood lymphoblastic leukemia (ALL) and is currently utilized in all major pediatric ALL protocols. MRD monitoring is done by multiparameter flow cytometry, IG/TCR quantitative PCR or reverse transcriptase quantitative PCR of leukemic fusion transcripts providing a reliable measurement of treatment response. However, occasionally bone marrow (BM) aspirates may not yield representative material or be misinterpreted due to treatment-induced changes in MRD marker profile, undetected subclones at diagnosis, contamination with peripheral blood or cell adhesion and stroma cell interactions posing a risk for underestimating MRD levels and misclassifying resistant disease that may be detected by traditional BM morphology methods, immunohistochemistry, karyotyping and FISH. We present four cases with high MRD levels where MRD monitoring failed to provide the correct stratification information. Through these cases, we discuss the continued need to consider all available information including BM smears, touch imprints and trephine biopsy preparations not only at diagnosis but throughout remission monitoring in pediatric ALL.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
414-419Informations de copyright
© 2020 APMIS. Published by John Wiley & Sons Ltd.
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