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Prepublished online as a Blood First Edition Paper on May 31, 2002; DOI 10.1182/blood-2002-04-1130. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-04-1130v1 100/7/2399    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Coustan-Smith, E. Articles by Campana, D. Search for Related Content PubMed PubMed Citation Articles by Coustan-Smith, E. Articles by Campana, D. Related Collections Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 October 2002, Vol. 100, No. 7, pp. 2399-2402 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Use of peripheral blood instead of bone marrow to monitor residual disease in children with acute lymphoblastic leukemia Elaine Coustan-Smith, Jose Sancho, Michael L. Hancock, Bassem I. Razzouk, Raul C. Ribeiro, Gaston K. Rivera, Jeffrey E. Rubnitz, John T. Sandlund, Ching-Hon Pui, and Dario Campana From the Departments of Hematology-Oncology, Biostatistics, and Pathology, St Jude Children's Research Hospital, and the University of Tennessee, Memphis. In children with acute lymphoblastic leukemia (ALL), response to treatment is assessed by bone marrow aspiration. We investigated whether minimal residual disease (MRD) can be effectively monitored in peripheral blood. We used flow cytometric techniques capable of detecting 1 leukemic cell among 10 000 or more normal cells to compare MRD measurements in 718 pairs of bone marrow and peripheral blood samples collected from 226 children during treatment for newly diagnosed ALL. MRD was detected in marrow and blood in 72 pairs and in marrow but not in blood in 67 pairs; it was undetectable in the remaining 579 pairs. Remarkably, findings in marrow and blood were completely concordant in the 150 paired samples from patients with T-lineage ALL: for each of the 35 positive marrow samples, the corresponding blood sample was positive. In B-lineage ALL, however, only 37 of 104 positive marrow samples had a corresponding positive blood sample. Notably, peripheral blood MRD in these patients was associated with a very high risk for disease recurrence. The 4-year cumulative incidence of relapse in patients with B-lineage ALL was 80.0% ± 24.9% for those who had peripheral blood MRD at the end of remission induction therapy but only 13.3% ± 9.1% for those with MRD confined to the marrow (P = .007). These results indicate that peripheral blood may be used to monitor MRD in patients with T-lineage ALL and that peripheral blood MRD may provide strong prognostic information in patients with B-lineage ALL. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. C. Bene and J. S. Kaeda How and why minimal residual disease studies are necessary in leukemia: a review from WP10 and WP12 of the European LeukaemiaNet Haematologica, August 1, 2009; 94(8): 1135 - 1150. [Abstract] [Full Text] [PDF] E. Coustan-Smith, J. T. Sandlund, S. L. Perkins, H. Chen, M. Chang, M. Abromowitch, and D. 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