Artículos de revistas
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
Fecha
2012Registro en:
LEUKEMIA & LYMPHOMA, LONDON, v. 53, n. 1, supl. 1, Part 3, pp. 89-U184, JAN, 2012
1042-8194
10.3109/10428194.2011.606939
Autor
Biojone, Estefania
Queiroz, Rosane De Paula
Valera, Elvis Terci
Odashima, Newton Satoro
Takayanagui, Osvaldo Massaiti
Viana, Marcos Borato
Tone, Luiz Gonzaga
Scrideli, Carlos Alberto
Institución
Resumen
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.