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Blood, 1 September 2007, Vol. 110, No. 5, pp. 1607-1611. Prepublished online as a Blood First Edition Paper on May 7, 2007; DOI 10.1182/blood-2006-09-045369. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2006-09-045369v1 110/5/1607    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 Zhou, J. Articles by Gribben, J. G. Search for Related Content PubMed PubMed Citation Articles by Zhou, J. Articles by Gribben, J. G. Related Collections Clinical Trials and Observations Neoplasia Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  NEOPLASIA Quantitative analysis of minimal residual disease predicts relapse in children with B-lineage acute lymphoblastic leukemia in DFCI ALL Consortium Protocol 95-01 Jianbiao Zhou1, Meredith A Goldwasser2, Aihong Li1, Suzanne E. Dahlberg2, Donna Neuberg2, Hongjun Wang1, Virginia Dalton3, Kathryn D McBride3, Stephen E. Sallan3,4, Lewis B Silverman3,4, John G. Gribben1, for the Dana-Farber Cancer Institute ALL Consortium 1 Department of Medical Oncology, 2 Biostatistics and Computational Biology, and 3 Pediatric Oncology, Dana-Farber Cancer Institute, and 4 Children's Hospital, Harvard Medical School, Boston, MA In a prospective trial in 284 children with B-lineage acute lymphoblastic leukemia (ALL), we assessed the clinical utility of real-time quantitative polymerase chain reaction analysis of antigen receptor gene rearrangements for detection of minimal residual disease (MRD) to identify children at high risk of relapse. At the end of induction therapy, the 5-year risk of relapse was 5% in 176 children with no detectable MRD and 44% in 108 children with detectable MRD (P < .001), with a linear association of the level of MRD and subsequent relapse. Recursive partitioning and clinical characteristics identified that the optimal cutoff level of MRD to predict outcome was 10–3. The 5-year risk of relapse was 12% for children with MRD less than one leukemia cell per 103 normal cells (low MRD) but 72% for children with MRD levels greater than this level (high MRD) (P < .001) and children with high MRD had a 10.5-fold greater risk of relapse. Based upon these results we have altered our treatment regimen for children with B-lineage ALL and children with MRD levels greater than or equal to 10–3 at the end of 4 weeks of multiagent induction chemotherapy now receive intensified treatment to attempt to decrease their risk of subsequent relapse. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. M. Davies, M. J. Borowitz, G. L. Rosner, K. Ritz, M. Devidas, N. Winick, P. L. Martin, P. Bowman, J. Elliott, C. Willman, et al. Pharmacogenetics of minimal residual disease response in children with B-precursor acute lymphoblastic leukemia: a report from the Children's Oncology Group Blood, March 15, 2008; 111(6): 2984 - 2990. [Abstract] [Full Text] [PDF]

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