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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 (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 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 Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted September 5, 2006 Accepted April 16, 2007 Quantitative analysis of minimal residual disease predicts relapse in children with B-lineage acute lymphoblastic leukemia in DFCI ALL consortium protocol 95-01 Jianbiao Zhou, Meredith A Goldwasser, Aihong Li, Suzanne E Dahlberg, Donna Neuberg, Hongjun Wang, Virginia Dalton, Kathryn D McBride, Stephen E Sallan, Lewis B Silverman, and John G Gribben* Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA Department of Biostatistical and Computational Biology, Dana-Farber Cancer Institute, Boston, MA Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA Children's Hospital, Harvard Medical School, Boston, MA * Corresponding author; email: john.gribben{at}cancer.org.uk. 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<0.0001), with a linear association of the level of MRD and subsequent relapse. Recursive partitioning and clinical characteristics identified that the optimal cut-off level of MRD to predict outcome was 10-3. The fiveyear 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<0.0001) 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 four weeks of multi-agent 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: M. J. Borowitz, M. Devidas, S. P. Hunger, W. P. Bowman, A. J. Carroll, W. L. Carroll, S. Linda, P. L. Martin, D. J. Pullen, D. Viswanatha, et al. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study Blood, June 15, 2008; 111(12): 5477 - 5485. [Abstract] [Full Text] [PDF] 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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