The significance of peripheral blood minimal residual disease to predict early disease response in patients with B‐cell acute lymphoblastic leukemia. (24th June 2016)

• Record Type: Journal Article
• Authors: Setiadi, A.; Owen, D.; Tsang, A.; Milner, R.; Vercauteren, S.
• Is Part Of: International journal of laboratory hematology. Volume 38:Number 5(2016:Oct.)
• Page Start: 527
• Page End: 534
• Publication Date: 2016-06-24
• Subjects: Acute lymphoblastic leukemia -- flow cytometry -- minimal residual disease; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Hematology -- Periodicals; 616.15005
• DOI: 10.1111/ijlh.12535
• Languages: English
• ISSNs: 1751-5521

Abstract

Summary: Introduction: Minimal residual disease (MRD) assessment in the bone marrow (BM) postinduction therapy is now standard of care in patients with B‐cell acute lymphoblastic leukemia (B‐ALL). We examined the use of peripheral blood as a less invasive means of MRD assessment at days 8 and 15 of induction therapy and established the cutoff level that would allow the most accurate prediction of BM MRD postinduction therapy. Methods: MRD analysis was performed using 5‐color flow cytometry on BM and PB samples from 77 B‐ALL patients. BM MRD at diagnosis and day 29 of induction therapy was analyzed using the following antibody combinations: CD45‐PC5/CD19‐PC7/CD20‐PE/CD10‐ECD/CD38‐FITC/CD13 + CD33‐PE/CD10‐ECD/CD34‐FITC. PB MRD at days 8 and 15 was determined using CD45‐PC5/CD19‐PC7/CD20‐ECD/CD10‐PE/CD34‐FITC. Results: Day 8 and day 15 PB MRD levels were significantly higher in patients who had persistent BM MRD at day 29. PB MRD <0.01% at day 8 and/or day 15 predicted negative day 29 BM MRD status with 100% sensitivity but poor specificity. ROC curve analysis showed that day 15 PB MRD level of 0.1% yielded the highest sensitivity (78%) and specificity (82%). Conclusions: PB MRD cutoff level of 0.1% at day 15 has the best predictive value in determining positive day 29 BM MRD.