Measurement of Residual Leukemia during Remission in Childhood Acute Lymphoblastic Leukemia

Roberts, WM; Estrov, Zeev; Ouspenskaia, Maia V.; Johnston, Dennis A.; McClain, Kenneth L.; Zipf, Theodore F.

doi:10.1056/nejm199701303360501

Cited by 169 publications

(74 citation statements)

References 23 publications

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“…Kaplan -Meier curves (Kaplan and Meier;1958) with log rank tests (Peto et al, 1977) were used to examine the relationship between MF exposure (TWAo0.1, 0.1 -0.19, 0.2 -0.29, 40.3 mT) and outcome. Event-free survival was defined as the interval of time from diagnosis to the date of last contact or to any of the following events that occurred: failure to attain a complete remission after induction therapy (Roberts et al, 1997), leukaemia relapse, secondary malignancy, or death from any cause. Removal for bone marrow transplantation was considered a censoring event (Pollock et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Magnetic field exposure and long-term survival among children with leukaemia

et al. 2006

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We examined the association between magnetic field (MF) exposure and survival among children with acute lymphoblastic leukaemia (ALL) treated at 51 Pediatric Oncology Group centres between 1996 and 2001. Of 1672 potentially eligible children under treatment, 482 (29%) participated and personal 24-h MF measurements were obtained from 412 participants. A total of 386 children with ALL and 361 with B-precursor ALL were included in the analysis of event-free survival (time from diagnosis to first treatment failure, relapse, secondary malignancy, or death) and overall survival. After adjustment for risk group and socioeconomic status, the event-free survival hazard ratio (HR) for children with measurements X0.3 mT was 1.9 (95% confidence interval (CI) 0.8, 4.9), compared to o0.1 mT. For survival, elevated HRs were found for children exposed to X0.3 mT (multivariate HR ¼ 4.5, 95% CI 1.5 -13.8) but based on only four deaths among 19 children. While risk was increased among children with exposures above 0.3 mT, the small numbers limited inferences for this finding.

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Section: Discussionmentioning

confidence: 99%

Magnetic field exposure and long-term survival among children with leukaemia

et al. 2006

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“…13,15,21 It is intriguing to interpret a very long period of clinical remission with the persistence of minimal residual disease, being detectable only by using very sensitive PCR techniques. 22 What mechanism(s) can suppress the malignant clone for so long a time and which events can lead to its re-emergence, are still unanswered questions.…”

Section: Discussionmentioning

confidence: 99%

Clonal stability in children with acute lymphoblastic leukemia (ALL) who relapsed five or more years after diagnosis

Nigro

Cazzaniga²,

Cataldo

et al. 1999

Leukemia

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Although most relapses of childhood acute lymphoblastic leukemia (ALL) occur 24-36 months after first CR has been achieved, few patients relapse 5 or more years after CR achievement. The assessment of clonality has proved to be useful in determining whether even those very late events represent the reoccurrence of the original clone or alternatively a secondary leukemia. To gain further information on clonal stability in such late relapse, we performed detailed comparative Southern blotting and PCR analyses of TcR␦ and TcR␥ gene rearrangements in five ALL at presentation and subsequent relapse which occurred more than 5 years after diagnosis. At least one stable rearranged allele of the TcR␦ and TcR␥ loci was traced in all cases at presentation and clinical relapse despite a wide heterogeneity of the pattern of rearrangements. Our study extends to a larger series of patients previous findings which have sought to analyze the phenomenon of clonal evolution in children relapsed after more than 5 years of CCR. With respect to the potential pitfalls in monitoring minimal residual disease in childhood ALL for the presence of clonal evolution, our results highlight the combination of two target genes (such as TcR␥ and TcR␦) as a tool to reduce false negative MRD results.

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“…The estimated tumor load of the four follow-up samples that were MRD positive with both RQ PCR methods were higher in three cases (cases [3][4][5] when measured with the ASO probe approach and slightly lower in case 6. The ratios of the corresponding MRD values estimated with the two methods varied from 0.9 to 5.9 in individual samples.…”

Section: Comparison Of Consensus Probes To Patient-specific Probes Fomentioning

confidence: 99%

“…Polymerase chain reaction (PCR) is the most sensitive and widely applicable method for MRD detection. [2][3][4][5][6][7] IgH gene rearrangements can be used as molecular targets for tumor-specific detection of MRD in about 90% of B-lineage ALL 1,7 and in approximately 80% of lymphoma and myeloma patients. 8 Traditional quantitative PCR assays usually rely on end point data collection resulting in PCR inherent quantitating problems as broad standard deviations of final PCR product amounts.…”

Section: Introductionmentioning

confidence: 99%

Improved assessment of minimal residual disease in B cell malignancies using fluorogenic consensus probes for real-time quantitative PCR

et al. 2000

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Measurement of Residual Leukemia during Remission in Childhood Acute Lymphoblastic Leukemia

Abstract: Molecular signs of residual leukemia can persist up to 35 months after the cessation of chemotherapy in children with ALL in remission. This suggests that eradication of all leukemia cells may not be a prerequisite for cure.

Cited by 169 publications

References 23 publications

Magnetic field exposure and long-term survival among children with leukaemia

Magnetic field exposure and long-term survival among children with leukaemia

Clonal stability in children with acute lymphoblastic leukemia (ALL) who relapsed five or more years after diagnosis

Improved assessment of minimal residual disease in B cell malignancies using fluorogenic consensus probes for real-time quantitative PCR

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