|
|
 Previous Article | Table of Contents | Next Article 
The immunologic detection of minimal residual disease in acute leukemia
[published erratum appears in Blood 1990 Nov 1;76(7):1901]
D Campana, E Coustan-Smith and G Janossy
Department of Immunology, Royal Free Hospital School of Medicine, London,
UK.
Certain combinations of differentiation antigens are expressed on leukemia
blasts and are absent or extremely rare among normal progenitors in the
fetal liver and fetal and regenerating bone marrow. These combinations
include cCD3/TdT, a thymic feature retained on thymic-acute lymphoblastic
leukemia (T-ALL) blasts outside the thymus, and the coexpression of TdT and
myeloid markers (CD13, CD33) on a proportion of ALL and acute myeloid
leukemia (AML). Thus, double marker immunofluorescence assays are
operationally leukemia-specific and can be applied in 35% of acute
leukemias for detecting minimal disease at a less than 10(-4) level; only
rare cases, 2 of 35 in our study, switch these relevant features during
relapse. The sensitivity and specificity of these assays was tested as
follows. First, bone marrow samples taken from patients who had originally
presented with blasts expressing the leukemia-associated combinations but
were in full morphologic remission were studied, and varying numbers (less
than 0.01% to 10% of the mononuclear fraction) of cells with aberrant
features were identified in 11.6% of the cases. Second, the outcome of 19
patients with minimal disease identified immunologically while in complete
morphologic remission was investigated: all 19 patients have developed
systemic relapse within 4 to 25 (median 14.5) weeks. In contrast, 17 of 25
patients also morphologically in complete remission and without residual
disease identifiable immunologically after repeated testing are still in
morphologic and immunologic remission (follow-up 17 to 114 weeks, median 28
weeks). Only eight patients in this group have relapsed so far: in two
patients the relapse was localized in the cerebrospinal fluid, while in six
patients a systemic relapse was observed 6 to 51 (median 21.5) weeks after
the last negative immunologic bone marrow examination. In conclusion, no
false-positive results were detected with these sensitive assays, and the
introduction of appropriately planned prospective studies, including the
immunologic detection of residual leukemia, is justified on the basis of
these observations.
Volume 76,
Issue 1,
pp. 163-171,
07/01/1990
Copyright © 1990 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]
|
|
|
|
|
|
|
A. Al-Mawali, D. Gillis, and I. Lewis
The Role of Multiparameter Flow Cytometry for Detection of Minimal Residual Disease in Acute Myeloid Leukemia
Am J Clin Pathol,
January 1, 2009;
131(1):
16 - 26.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. N. Dworzak, G. Froschl, D. Printz, G. Mann, U. Potschger, N. Muhlegger, G. Fritsch, and H. Gadner
Prognostic significance and modalities of flow cytometric minimal residual disease detection in childhood acute lymphoblastic leukemia
Blood,
March 15, 2002;
99(6):
1952 - 1958.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Feuring-Buske and D. E. Hogge
Hoechst 33342 efflux identifies a subpopulation of cytogenetically normal CD34+CD38{-} progenitor cells from patients with acute myeloid leukemia
Blood,
June 15, 2001;
97(12):
3882 - 3889.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Brown and C. Wittwer
Flow Cytometry: Principles and Clinical Applications in Hematology
Clin. Chem.,
August 1, 2000;
46(8):
1221 - 1229.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Orfao, G. Schmitz, B. Brando, A. Ruiz-Arguelles, G. Basso, R. Braylan, G. Rothe, F. Lacombe, F. Lanza, S. Papa, et al.
Clinically Useful Information Provided by the Flow Cytometric Immunophenotyping of Hematological Malignancies: Current Status and Future Directions
Clin. Chem.,
October 1, 1999;
45(10):
1708 - 1717.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. K. Rivera, D. Pinkel, J. V. Simone, M. L. Hancock, and W. M. Crist
Treatment of Acute Lymphoblastic Leukemia -- 30 Years' Experience at St. Jude Children's Research Hospital
N. Engl. J. Med.,
October 28, 1993;
329(18):
1289 - 1295.
[Abstract]
[Full Text]
|
|
|
|
|
