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Della Starza, Irene; Nunes, Vittorio; Lovisa, Federica; Silvestri, Daniela; Cavalli, Marzia; Garofalo, Andrea; Campeggio, Mimma; De Novi, Lucia Anna; Soscia, Roberta; Oggioni, Carlotta; Mussolin, Lara; Biondi, Andrea; Guarini, Anna; Valsecchi, Maria Grazia; Conter, Valentino; Biffi, Alessandra; Basso, Giuseppe; Foà, Robin; Cazzaniga, Giovanni
HemaSphere, March 2021, Letnik: 5, Številka: 3Journal Article
Minimal residual disease (MRD) is the most powerful prognostic factor in pediatric acute lymphoblastic leukemia (ALL). Real‐time quantitative polymerase chain reaction (RQ‐PCR) represents the gold standard for molecular MRD assessment and risk‐based stratification of front‐line treatment. In the protocols of the Italian Association of Pediatric Hematology and Oncology (AIEOP) and the Berlin‐Frankfurth‐Munschen (BFM) group AIEOP‐BFM ALL2009 and ALL2017, B‐lineage ALL patients with high RQ‐PCR‐MRD at day+33 and positive at day+78 are defined slow early responders (SERs). Based on results of the AIEOP‐BFM ALL2000 study, these patients are treated as high‐risk also when positive MRD signal at day +78 is below the lower limit of quantification of RQ‐PCR (“positive not‐quantifiable,” POS‐NQ). To assess whether droplet digital polymerase chain reaction (ddPCR) could improve patients’ risk definition, we analyzed MRD in 209 pediatric B‐lineage ALL cases classified by RQ‐PCR as POS‐NQ and/or negative (NEG) at days +33 and/or +78 in the AIEOP‐BFM ALL2000 trial. ddPCR MRD analysis was performed on 45 samples collected at day +78 from SER patients, who had RQ‐PCR MRD ≥ 5.0 × 10–4 at day+33 and POS‐NQ at day+78 and were treated as medium risk (MR). The analysis identified 13 of 45 positive quantifiable cases. Most relapses occurred in this patients’ subgroup, while ddPCR NEG or ddPCR‐POS‐NQ patients had a significantly better outcome (P < 0.001). Overall, in 112 MR cases and 52 standard‐risk patients, MRD negativity and POS‐NQ were confirmed by the ddPCR analysis except for a minority of cases, for whom no differences in outcome were registered. These data indicate that ddPCR is more accurate than RQ‐PCR in the measurement of MRD, particularly in late follow‐up time points, and may thus allow improving patients’ stratification in ALL protocols.
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Dostop do baze podatkov JCR je dovoljen samo uporabnikom iz Slovenije. Vaš trenutni IP-naslov ni na seznamu dovoljenih za dostop, zato je potrebna avtentikacija z ustreznim računom AAI.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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