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Minimal residual disease monitoring cannot fully replace bone marrow morphology in assessing disease status in pediatric acute lymphoblastic leukemia

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@article{e65479499deb4c9caa50a4ee01327a09,
title = "Minimal residual disease monitoring cannot fully replace bone marrow morphology in assessing disease status in pediatric acute lymphoblastic leukemia",
abstract = "Minimal residual disease (MRD) monitoring has a strong prognostic value in childhood lymphoblastic leukemia (ALL) and is currently utilized in all major pediatric ALL protocols. MRD monitoring is done by multiparameter flow cytometry, IG/TCR quantitative PCR or reverse transcriptase quantitative PCR of leukemic fusion transcripts providing a reliable measurement of treatment response. However, occasionally bone marrow (BM) aspirates may not yield representative material or be misinterpreted due to treatment-induced changes in MRD marker profile, undetected subclones at diagnosis, contamination with peripheral blood or cell adhesion and stroma cell interactions posing a risk for underestimating MRD levels and misclassifying resistant disease that may be detected by traditional BM morphology methods, immunohistochemistry, karyotyping and FISH. We present four cases with high MRD levels where MRD monitoring failed to provide the correct stratification information. Through these cases, we discuss the continued need to consider all available information including BM smears, touch imprints and trephine biopsy preparations not only at diagnosis but throughout remission monitoring in pediatric ALL.",
keywords = "Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Bone Marrow/pathology, Child, Child, Preschool, Female, Flow Cytometry, Humans, Immunophenotyping, Male, Neoplasm Recurrence, Local/diagnosis, Neoplasm, Residual/diagnosis, Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis, Remission Induction",
author = "Mathias Rathe and Birgitte Preiss and Marquart, {Hanne Vibeke} and Kjeld Schmiegelow and Wehner, {Peder Skov}",
note = "{\textcopyright} 2020 APMIS. Published by John Wiley & Sons Ltd.",
year = "2020",
month = may,
doi = "10.1111/apm.13037",
language = "English",
volume = "128",
pages = "414--419",
journal = "APMIS - Journal of Pathology, Microbiology and Immunology",
issn = "0903-4641",
publisher = "Wiley Online",
number = "5",

}

RIS

TY - JOUR

T1 - Minimal residual disease monitoring cannot fully replace bone marrow morphology in assessing disease status in pediatric acute lymphoblastic leukemia

AU - Rathe, Mathias

AU - Preiss, Birgitte

AU - Marquart, Hanne Vibeke

AU - Schmiegelow, Kjeld

AU - Wehner, Peder Skov

N1 - © 2020 APMIS. Published by John Wiley & Sons Ltd.

PY - 2020/5

Y1 - 2020/5

N2 - Minimal residual disease (MRD) monitoring has a strong prognostic value in childhood lymphoblastic leukemia (ALL) and is currently utilized in all major pediatric ALL protocols. MRD monitoring is done by multiparameter flow cytometry, IG/TCR quantitative PCR or reverse transcriptase quantitative PCR of leukemic fusion transcripts providing a reliable measurement of treatment response. However, occasionally bone marrow (BM) aspirates may not yield representative material or be misinterpreted due to treatment-induced changes in MRD marker profile, undetected subclones at diagnosis, contamination with peripheral blood or cell adhesion and stroma cell interactions posing a risk for underestimating MRD levels and misclassifying resistant disease that may be detected by traditional BM morphology methods, immunohistochemistry, karyotyping and FISH. We present four cases with high MRD levels where MRD monitoring failed to provide the correct stratification information. Through these cases, we discuss the continued need to consider all available information including BM smears, touch imprints and trephine biopsy preparations not only at diagnosis but throughout remission monitoring in pediatric ALL.

AB - Minimal residual disease (MRD) monitoring has a strong prognostic value in childhood lymphoblastic leukemia (ALL) and is currently utilized in all major pediatric ALL protocols. MRD monitoring is done by multiparameter flow cytometry, IG/TCR quantitative PCR or reverse transcriptase quantitative PCR of leukemic fusion transcripts providing a reliable measurement of treatment response. However, occasionally bone marrow (BM) aspirates may not yield representative material or be misinterpreted due to treatment-induced changes in MRD marker profile, undetected subclones at diagnosis, contamination with peripheral blood or cell adhesion and stroma cell interactions posing a risk for underestimating MRD levels and misclassifying resistant disease that may be detected by traditional BM morphology methods, immunohistochemistry, karyotyping and FISH. We present four cases with high MRD levels where MRD monitoring failed to provide the correct stratification information. Through these cases, we discuss the continued need to consider all available information including BM smears, touch imprints and trephine biopsy preparations not only at diagnosis but throughout remission monitoring in pediatric ALL.

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Bone Marrow/pathology

KW - Child

KW - Child, Preschool

KW - Female

KW - Flow Cytometry

KW - Humans

KW - Immunophenotyping

KW - Male

KW - Neoplasm Recurrence, Local/diagnosis

KW - Neoplasm, Residual/diagnosis

KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis

KW - Remission Induction

U2 - 10.1111/apm.13037

DO - 10.1111/apm.13037

M3 - Journal article

C2 - 32108963

VL - 128

SP - 414

EP - 419

JO - APMIS - Journal of Pathology, Microbiology and Immunology

JF - APMIS - Journal of Pathology, Microbiology and Immunology

SN - 0903-4641

IS - 5

ER -

ID: 62070065