We recently reported that minimal residual disease (MRD) and minimal disseminated disease (MDD), assessed by longdistance PCR (LD-PCR) for t (8;14), are negative prognostic factors in mature B-cell acute lymphoblastic leukemia (B-ALL) and in Burkitt's lymphoma (BL). However, t(8;14) is detectable in only about 70% of patients, thus preventing MRD studies by this approach in the remaining patients. At present, no molecular assays have been reported for MRD and MDD analysis in t(8;14)-negative patients. The aim of our study was to evaluate the characteristics of patient-specific immunoglobulin (Ig) gene rearrangements as RQ-PCR targets for MRD analysis, in order to extend MRD studies to those patients who are not eligible for the LD-PCR assay. The study was performed according to the guidelines of the European Study Group on MRD detection in ALL (ESG-MRD-ALL). Overall, 36 B-ALL and 19 BL cases were analyzed. Multiple PCR reactions were performed for each sample to identify heavy and kappa light-chain rearrangements. A total of 97 RQ-PCR targets (62 for B-ALL, 35 for BL) were analyzed for sensitivity. The rearrangement pattern identified was similar to that reported for normal peripheral blood lymphocytes. In 88% of the targets, a sensitivity of at least 10 À4 was achieved. In 87% of patients (84% of B-ALLs, 95% of BLs) at least one sensitive target was available. All PCR targets identified at diagnosis were preserved at relapse. Our results suggest that MDD and MRD can be successfully studied using a single sensitive Ig target in the great majority of B-ALL and BL cases. The combination of LD-PCR and Ig-based assays will allow MRD analysis in virtually all of the patients. KEYWORDS: B-cell acute lymphoblastic leukemia; Burkitt's lymphoma; child; clonality; immunoglobulin rearrangement; minimal residual disease Mature B-cell lymphoblastic leukemia (B-ALL) and Burkitt's lymphoma (BL) of childhood are often considered to be different manifestations of BL rather than different diseases. 1 Both are characterized by the expression of mature B-cell surface markers, including CD19, CD20 and immunoglobulin (Ig)M. 2 The chromosomal translocation t(8;14)(q24;q32) can be identified in about 70% of B-ALL and 70-75% of BL cases. 3,4 The amplification by long-distance PCR (LD-PCR) of this translocation breakpoint is currently used to monitor minimal residual disease (MRD) in patients enrolled in the Italian Association of Pediatric Hematology-Oncology (AIEOP) national protocol NHL-97. Using this approach, we have recently reported that minimal disseminated disease (MDD) in BL has a negative prognostic impact on the outcome, being often associated with advanced stage disease and high levels of serum LDH. 5 In addition, using multivariate analysis, we demonstrated that MRD was predictive of higher risk of failure in children with mature B-ALL. 6 All together, these data suggest that, similar to other subtypes of ALL, a MRD-based risk group classification could be conceived for BL and mature B-ALL, and that this information might b...