Minimal residual disease in cerebrospinal fluid at diagnosis: a more intensive treatment protocol was able to eliminate the adverse prognosis in children with acute lymphoblastic leukemia
Contribuinte(s) |
UNIVERSIDADE DE SÃO PAULO |
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Data(s) |
14/10/2013
14/10/2013
2012
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Resumo |
We analyzed cerebrospinal fluid (CSF) samples from 65 consecutive children with acute lymphoblastic leukemia (ALL) treated according to two different treatment protocols (GBTLI-ALL-93 and -99) with no puncture accident for minimal residual disease (MRD) in the central nervous system (CNS). Minimal residual disease was detected by polymerase chain reaction (PCR) with homo/heteroduplex analysis using consensus primers to IgH and TCR genes. MRD in the CSF at diagnosis was detected by PCR in 46.8% of children with no puncture accident or morphological involvement. In patients treated with GBTLI-ALL-93 a significantly lower 5-year event-free survival (EFS) was demonstrated for those with CSF involvement, in univariate (p = 0.01) and multivariate (p = 0.04) analysis. This observation was not true for patients treated with the more intensive protocol GBTLI-ALL-99 (p = 0.81). These findings suggest that MRD detection in the CSF is a common event in children with ALL. Treatment intensification provided by the GBTLI-ALL-99 apparently overcomes the detrimental effect of CNS minimal residual disease at diagnosis. Brazilian Public Financial Support Agency FAPESP [2005/02279-6] Brazilian Public Financial Support Agency FAPESP Brazilian Public Financial Support Agency CNPq Brazilian Public Financial Support Agency CNPq Brazilian Public Financial Support Agency FAEPA Brazilian Public Financial Support Agency FAEPA |
Identificador |
LEUKEMIA & LYMPHOMA, LONDON, v. 53, n. 1, supl. 1, Part 3, pp. 89-U184, JAN, 2012 1042-8194 http://www.producao.usp.br/handle/BDPI/34434 10.3109/10428194.2011.606939 |
Idioma(s) |
eng |
Publicador |
INFORMA HEALTHCARE LONDON |
Relação |
LEUKEMIA & LYMPHOMA |
Direitos |
restrictedAccess Copyright INFORMA HEALTHCARE |
Palavras-Chave | #MINIMAL RESIDUAL DISEASE #CEREBROSPINAL FLUID #CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA #IMMUNOGLOBULIN #T-CELL RECEPTOR #GENE REARRANGEMENTS #TRAUMATIC LUMBAR PUNCTURE #POLYMERASE-CHAIN-REACTION #CENTRAL-NERVOUS-SYSTEM #LOW LEUKOCYTE COUNTS #CANCER GROUP #TOTAL THERAPY #CELL-COUNT #CHILDHOOD #BLASTS #CSF #ONCOLOGY #HEMATOLOGY |
Tipo |
article original article publishedVersion |