Disease detection methodologies in relapsed B-cell acute lymphoblastic leukemia: Opportunities for improvement.
Background: Accurate disease detection is integral to risk stratification in B-cell acute lymphoblastic leukemia (ALL). The gold standard used to evaluate response in the United States includes morphologic evaluation and minimal residual disease (MRD) testing of aspirated bone marrow (BM) by flow cy...
| Publicado en: | Pediatric Blood & Cancer Vol. 67; no. 4; pp. 1 - 9 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141878898&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141878898 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15455009 1XL2 jtl: Pediatric Blood & Cancer issn: 15455009 maglogo: Y pubinfo: dt: Apr2020 vid: 67 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 141878898 141878898 145849977 NLM31981407 141878898 10.1002/pbc.28149 NLM31981407 141878898 ppf: 1 ppct: 8 formats: tig: atl: Disease detection methodologies in relapsed B-cell acute lymphoblastic leukemia: Opportunities for improvement. aug: au: Shalabi, Haneen Yuan, Constance M. Kulshreshtha, Amita Dulau‐Florea, Alina Salem, Dalia Gupta, Gaurav K. Roth, Mark Filie, Armando C. Yates, Bonnie Delbrook, Cindy Derdak, Joanne Mackall, Crystal L. Lee, Daniel W. Fry, Terry J. Wayne, Alan S. Stetler‐Stevenson, Maryalice Shah, Nirali N. Dulau-Florea, Alina Stetler-Stevenson, Maryalice affil: Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda Maryland sug: subj: Neoplastic Processes Pathology Hematopoietic Stem Cell Transplantation Methods Flow Cytometry Methods Bone Marrow Pathology Leukemia, Lymphocytic, Acute Pathology Neoplasm Recurrence, Local Pathology Female Adolescence Neoplastic Processes Therapy Neoplasm Recurrence, Local Therapy Immunophenotyping Leukemia, Lymphocytic, Acute Therapy Male Prospective Studies Child, Preschool Retrospective Design Adult Young Adult Child Prognosis Impact of Events Scale Scales Funding Source Adolescent: 13-18 years Child, Preschool: 2-5 years Adult: 19-44 years Child: 6-12 years Female Male ab: Background: Accurate disease detection is integral to risk stratification in B-cell acute lymphoblastic leukemia (ALL). The gold standard used to evaluate response in the United States includes morphologic evaluation and minimal residual disease (MRD) testing of aspirated bone marrow (BM) by flow cytometry (FC). This MRD assessment is usually made on a single aspirate sample that is subject to variability in collection techniques and sampling error. Additionally, central nervous system (CNS) assessments for ALL include evaluations of cytopathology and cell counts, which can miss subclinical involvement.Procedure: We retrospectively compared BM biopsy, aspirate, and FC samples obtained from children and young adults with relapsed/refractory ALL to identify the frequency and degree of disease discrepancies in this population. We also compared CNS FC and cytopathology techniques.Results: Sixty of 410 (14.6%) BM samples had discrepant results, 41 (10%) of which were clinically relevant as they resulted in a change in the assignment of marrow status. Discrepant BM results were found in 28 of 89 (31.5%) patients evaluated. Additionally, cerebrospinal fluid (CSF) FC identified disease in 9.7% of cases where cytopathology was negative.Conclusions: These results support further investigation of the role of concurrent BM biopsy, with aspirate and FC evaluations, and the addition of FC to CSF evaluations, to fully assess disease status and response, particularly in patients with relapsed/refractory ALL. Prospective studies incorporating more comprehensive analysis to evaluate the impact on clinical outcomes are warranted. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|