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Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 June 2002, Vol. 99, No. 12, pp. 4386-4393 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Detection of minimal residual disease identifies differences in treatment response between T-ALL and precursor B-ALL Marja J. Willemse, Taku Seriu, Klaudia Hettinger, Elisabetta d'Aniello, Wim C. J. Hop, E. Renate Panzer-Grümayer, Andrea Biondi, Martin Schrappe, Willem A. Kamps, Guiseppe Masera, Helmut Gadner, Hansjoerg Riehm, Claus R. Bartram, and Jacques J. M. van Dongen From the Departments of Immunology and of Epidemiology and Biostatistics, University Hospital Rotterdam/Erasmus University Rotterdam; Dutch Childhood Leukemia Study Group, The Hague; Department of Pediatrics, University Hospital Groningen, The Netherlands; Institute of Human Genetics, University of Heidelberg; Department of Pediatrics, Medizinische Hochschule Hannover, Germany; Children's Cancer Research Institute, St Anna Kinderspital, Vienna, Austria; and Department of Pediatrics, University of Milano, Ospedale S. Gerardo, Monza, Italy. We performed sensitive polymerase chain reaction-based minimal residual disease (MRD) analyses on bone marrow samples at 9 follow-up time points in 71 children with T-lineage acute lymphoblastic leukemia (T-ALL) and compared the results with the precursor B-lineage ALL (B-ALL) results (n = 210) of our previous study. At the first 5 follow-up time points, the frequency of MRD-positive patients and the MRD levels were higher in T-ALL than in precursor-B-ALL, reflecting the more frequent occurrence of resistant disease in T-ALL. Subsequently, patients were classified according to their MRD level at time point 1 (TP1), taken at the end of induction treatment (5 weeks), and at TP2 just before the start of consolidation treatment (3 months). Patients were considered at low risk if TP1 and TP2 were MRD negative and at high risk if MRD levels at TP1 and TP2 were 103 or higher; remaining patients were considered at intermediate risk. The relative distribution of patients with T-ALL (n = 43) over the MRD-based risk groups differed significantly from that of precursor B-ALL (n = 109). Twenty-three percent of patients with T-ALL and 46% of patients with precursor B-ALL were classified in the low-risk group (P = .01) and had a 5-year relapse-free survival (RFS) rate of 98% or greater. In contrast, 28% of patients with T-ALL were classified in the MRD-based high-risk group compared to only 11% of patients with precursor B-ALL (P = .02), and the RFS rates were 0% and 25%, respectively (P = .03). Not only was the distribution of patients with T-ALL different over the MRD-based risk groups, the prognostic value of MRD levels at TP1 and TP2 was higher in T-ALL (larger RFS gradient), and consistently higher RFS rates were found for MRD-negative T-ALL patients at the first 5 follow-up time points. © 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: C. A. Scrideli, J. G. Assumpcao, M. A. Ganazza, M. Araujo, S. R. Toledo, M. L. M. Lee, E. Delbuono, A. S. Petrilli, R. P. Queiroz, A. Biondi, et al. 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