SEARCH:   Advanced

Prepublished online as a Blood First Edition Paper on December 27, 2002; DOI 10.1182/blood-2002-10-3064. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-10-3064v1 101/9/3398    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 Sievers, E. L. Articles by Loken, M. R. Search for Related Content PubMed PubMed Citation Articles by Sievers, E. L. Articles by Loken, M. R. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 May 2003, Vol. 101, No. 9, pp. 3398-3406 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Immunophenotypic evidence of leukemia after induction therapy predicts relapse: results from a prospective Children's Cancer Group study of 252 patients with acute myeloid leukemia Eric L. Sievers, Beverly J. Lange, Todd A. Alonzo, Robert B. Gerbing, Irwin D. Bernstein, Franklin O. Smith, Robert J. Arceci, William G. Woods, and Michael R. Loken From the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; the Department of Pediatrics, University of Washington, Seattle, WA; Hematologics, Inc, Seattle, WA; the Division of Oncology, Children's Hospital of Philadelphia, PA; the Department of Preventative Medicine, University of Southern California, Los Angeles; the Division of Hematology and Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; the Division of Pediatric Oncology and the Department of Oncology and Pediatrics, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pediatric Hematology-Oncology-BMT, Children's Healthcare of Atlanta/Emory University, Atlanta, GA; and the Children's Oncology Group, Arcadia, CA. Approximately 40% of children with acute myeloid leukemia (AML) who respond to initial therapy subsequently relapse. Multidimensional flow cytometry employing a standardized panel of monoclonal antibodies enables the detection of small numbers of occult leukemic cells that persist during therapy using technology adaptable by most clinical laboratories. We performed a prospective, blinded evaluation of bone marrow specimens obtained from 252 pediatric patients with de novo AML to determine whether detection of occult leukemia defined as more than or equal to 0.5% blasts with aberrant surface antigen expression as determined by flow cytometry was predictive of subsequent relapse. Occult leukemia was detected in 41 (16%) of the 252 patients who responded to initial induction therapy. In time-dependent multivariate analyses that controlled for allogeneic marrow transplantation, variable intervals between sample submission, age, sex, white blood cell count at diagnosis, presence of splenomegaly or hepatomegaly, and presence of more than 15% blasts in the marrow after the first course of induction, patients harboring occult leukemia were 4.8 times more likely to relapse (95% confidence interval [CI] = 2.8 to 8.4, P < .0001) and 3.1 times more likely to die (95% CI; 1.9 to 5.1, P < .0001) than those lacking leukemia detectable by flow cytometry. In this analysis, flow cytometric evidence of leukemia after the initiation of therapy emerged as the most powerful independent prognostic factor associated with poor outcome. Among patients in whom a marrow sample was available for analysis at the end of consolidation therapy, overall survival at 3 years was 41% versus 69% for patients with and without occult leukemia, respectively (P = .0058). © 2003 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: D. Cilloni, F. Messa, F. Arruga, I. Defilippi, E. Gottardi, M. Fava, S. Carturan, R. Catalano, E. Bracco, E. Messa, et al. Early prediction of treatment outcome in acute myeloid leukemia by measurement of WT1 transcript levels in peripheral blood samples collected after chemotherapy Haematologica, June 1, 2008; 93(6): 921 - 924. [Abstract] [Full Text] [PDF] F. E. Craig and K. A. Foon Flow cytometric immunophenotyping for hematologic neoplasms Blood, April 15, 2008; 111(8): 3941 - 3967. [Abstract] [Full Text] [PDF] B. J. Lange, F. O. Smith, J. Feusner, D. R. Barnard, P. Dinndorf, S. Feig, N. A. Heerema, C. Arndt, R. J. Arceci, N. Seibel, et al. Outcomes in CCG-2961, a Children's Oncology Group Phase 3 Trial for untreated pediatric acute myeloid leukemia: a report from the Children's Oncology Group Blood, February 1, 2008; 111(3): 1044 - 1053. [Abstract] [Full Text] [PDF] L. Maurillo, F. Buccisano, A. Spagnoli, G. Del Poeta, P. Panetta, B. Neri, M. I. Del Principe, C. Mazzone, M. I. Consalvo, A. Tamburini, et al. Monitoring of minimal residual disease in adult acute myeloid leukemia using peripheral blood as an alternative source to bone marrow Haematologica, May 1, 2007; 92(5): 605 - 611. [Abstract] [Full Text] [PDF] S. Meshinchi, T. A. Alonzo, D. L. Stirewalt, M. Zwaan, M. Zimmerman, D. Reinhardt, G. J. L. Kaspers, N. A. Heerema, R. Gerbing, B. J. Lange, et al. Clinical implications of FLT3 mutations in pediatric AML Blood, December 1, 2006; 108(12): 3654 - 3661. [Abstract] [Full Text] [PDF] J. A. Pollard, T. A. Alonzo, R. B. Gerbing, W. G. Woods, B. J. Lange, D. A. Sweetser, J. P. Radich, I. D. Bernstein, and S. Meshinchi FLT3 internal tandem duplication in CD34+/CD33- precursors predicts poor outcome in acute myeloid leukemia Blood, October 15, 2006; 108(8): 2764 - 2769. [Abstract] [Full Text] [PDF] C. Langebrake, U. Creutzig, M. Dworzak, O. Hrusak, E. Mejstrikova, F. Griesinger, M. Zimmermann, and D. Reinhardt Residual Disease Monitoring in Childhood Acute Myeloid Leukemia by Multiparameter Flow Cytometry: The MRD-AML-BFM Study Group J. Clin. Oncol., August 1, 2006; 24(22): 3686 - 3692. [Abstract] [Full Text] [PDF] D. Steinbach, A. Schramm, A. Eggert, M. Onda, K. Dawczynski, A. Rump, I. Pastan, S. Wittig, N. Pfaffendorf, A. Voigt, et al. Identification of a Set of Seven Genes for the Monitoring of Minimal Residual Disease in Pediatric Acute Myeloid Leukemia Clin. Cancer Res., April 15, 2006; 12(8): 2434 - 2441. [Abstract] [Full Text] [PDF] H. Lapillonne, A. Renneville, A. Auvrignon, C. Flamant, A. Blaise, C. Perot, J.-L. Lai, P. Ballerini, F. Mazingue, S. Fasola, et al. High WT1 Expression After Induction Therapy Predicts High Risk of Relapse and Death in Pediatric Acute Myeloid Leukemia J. Clin. Oncol., April 1, 2006; 24(10): 1507 - 1515. [Abstract] [Full Text] [PDF] B. N. Mandrell and M. Pritchard Understanding the Clinical Implications of Minimal Residual Disease in Childhood Leukemia Journal of Pediatric Oncology Nursing, January 1, 2006; 23(1): 38 - 44. [Abstract] [PDF]

	Copyright © 2003 by American Society of Hematology         Online ISSN: 1528-0020