Clinical significance of low levels of minimal residual disease at the end of remission induction therapy in childhood acute lymphoblastic leukemia

Absence of terminal deoxynucleotidyl transferase expression identifies a subset of high-risk adult T-lymphoblastic leukemia/lymphoma

“…13 This finding suggests that therapy modulates TdT expression, either by promoting maturation of neoplastic cells or by selecting preexistent TdTnegative cells. As MRD at the end of induction is one of the most significant risk factors for predicting relapse and adverse outcome in patients with T-ALL/LBL, [14][15][16][17] diminished or absent TdT expression may be a marker of chemoresistance. This finding, along with the few case reports of TdT-negative T-ALL/LBL with poor prognosis, therefore prompted us to query if negative/low TdT in T-ALL/LBL is associated with an adverse outcome to frontline chemotherapy.…”

The long-term impact of in vitro drug sensitivity on risk stratification and treatment outcome in acute lymphoblastic leukemia of childhood (CoALL 06-97)

“…[5][6][7]17,18 In patients with Bprecursor ALL the NOPHO group observed a significant correlation between MRD level at day 15 (i.e. after induction) and in vitro sensitivity to prednisolone, vincristine and doxorubicin, drugs that were used in the induction therapy.…”

“…Several studies showed that regular assessment of MRD by polymerase chain reaction (PCR) analysis or flow cytometry does indeed facilitate the identification of patients with a high or low risk of relapse. [5][6][7]17,18 While both MRD and the PVA score have been used for treatment stratification in different clinical trials, there are only two small retrospective 19,20 and one prospective study 21 investigating a potential relationship between MRD and in vitro chemoresistance. They revealed a weak correlation between MRD and response to single drugs such as prednisolone and doxorubicin.…”

Treatment of Pediatric Acute Lymphoblastic Leukemia and Recent Advances

“…and Campana, 2000). Recent studies indicated that monitoring of MRD constituted an essential prognostic marker, and that detection of MRD, particularly at the end of induction and after treatment www.intechopen.com completion, was significantly predictive for patient outcome (Katsibardi et al, 2010;Stow et al, 2010).…”