Impact of Minimal Residual Disease Detection by Next Generation Flow Cytometry on Outcome of Egyptian Patients with Acute Lymphoblastic Leukemia

Abstract

Introduction: Recently, the identification of minimal residual disease (MRD) that persists after chemotherapy has emerged as the most powerful tool in determining the prognosis of patients with acute lymphoblastic leukemia (ALL). Multiple methods to detect MRD exist, each with its own benefits and drawback. Multiparameter flow cytometry and quantitative polymerase chain reaction are the most commonly used methods of MRD detection in clinical practice. Objective: to evaluate the impact of minimal residual disease detection by Next Generation Flow Cytometry on Outcome of Egyptian Patients with Acute Lymphoblastic Leukemia. Patients &Methods: The study conducted on 93 patients with recently diagnosed acute lymphoblastic leukemia. MRD detection was evaluated during follow up of patient (at End of induction EOI and End of consolidation EOC by next generation flow cytometry. Results: Out of 93 patients, 28 (30%) had positive MRD at EOI. Age, BCR-ABL, risk assessment, and relapse had a substantial impact on MRD at EOI (P <0.005). Fourteen patients (17.9%) at EOC were MRD positive; age, hemoglobin, blast count at diagnosis, BCR-ABL, risk stratification, relapse and overall survival showed significant association. Conclusion: Positive MRD was a major risk factor for predicting poor survival and relapse at both EOI and EOC by cox regression analysis.