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

Autor(es)

Biojone, Estefania ^[1] ; Queiroz, Rosane De Paula ^[1] ; Valera, Elvis Terci ^[1] ; Odashima, Newton Satoro ^[2] ; Takayanagui, Osvaldo Massaiti ^[2] ; Viana, Marcos Borato ^[3] ; Tone, Luiz Gonzaga ^[1] ; Scrideli, Carlos Alberto ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Pediat, Ribeirao Preto Med Sch, BR-14048900 Ribeirao Preto, SP - Brazil

^[2] Univ Sao Paulo, Dept Neurosci & Behav Sci, Ribeirao Preto Med Sch, BR-14048900 Ribeirao Preto, SP - Brazil

^[3] Univ Fed Minas Gerais, Dept Pediat, Belo Horizonte, MG - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Leukemia & Lymphoma; v. 53, n. 1, p. 89-U184, JAN 2012.
• Citações Web of Science: 11

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. (AU)

• Processo FAPESP: 05/02279-6 - Estudo de doença residual mínima em leucemia linfóide aguda da criança e do adolescente
• Beneficiário: Carlos Alberto Scrideli
• Modalidade de apoio: Auxílio à Pesquisa - Regular