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MONITORING OF MINIMAL RESIDUAL DISEASE IN BONE MARROW AND PERIPHERAL BLOOD IN PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA
PRAĆENJE MINIMALNE REZIDUALNE BOLESTI U KOSTNOJ SRŽI I PERIFERNOJ KRVI KOD PACIJENATA SA AKUTNOM LIMFOBLASTOM LEUKEMIJOM

Authors

 

Zorana Kozić1, Bojana Cikota-Aleksić1, Olivera Tarabar2, Dragana Stamatović2, Zvonko Magić1

1Institute of medical research and /Institut za medicinska istraživanja i
2Clinic for hematology, Military Medical Academy, Belgrade, Serbia / Klinika za hematologiju, Vojnomedicinske Akademije

 


Rad je primljen 14.11.2017. / Prihvaćen 16.11.2017.

 


Correspondence to


Dr Zorana Kozić spec.biol.,
Vojnomedicinska akademija,
Beograd, Srbija
Crnotravska 17
e-mail: zinzoran@gmail.com

 

 

Abstract

 

Modern treatment protocols for acute lymphoblastic leukemia (ALL) include the analysis of minimal residual disease (MRD), the detection of small number of malignant cells that survived after therapy. MRD diagnostics represents the most sensitive method to evaluate treatment response and the strongest prognostic factor in ALL patients. Detection of MRD is commonly based on polymerase chain reaction (PCR) analysis of rearranged immunoglobuline heavy chain (IGH) or T-cell receptor (TCR) genes in bone marrow (BM) samples. Since BM sampling is invasive and traumatic, the aim of this study was to evaluate clinical usefulness of MRD monitoring in the peripheral blood (PB). The study included 59 patients with ALL (44 B-ALL and 15 T- ALL). Samples of PB and BM were taken after induction therapy and during the follow-up. Clonality testing was based on PCR analyses of rearranged IGH or TCR gamma genes. In patients with B-ALL, MRD was detected in BM of 10 patients and in PB of 6 patients. In T-ALL, MRD was detected in BM of 7 patients and in PB of 6 patients. Obtained results indicated that in patients with B-ALL MRD assessment of BM is more informative than analysis of PB, while in T-ALL traumatic BM sampling might be replaced with PB.

 

 

 

Key words:

minimal residual disease (MRD), acute lymphoblastic leukemia (ALL), bone marrow (BM)

 

 

Sažetak

 

Savremeni protokoli za lečenje akutne limfoblastne leukemije (ALL) uključuju analizu minimalne rezidualne bolesti (MRD), otkrivanje malih količina malignih ćelija koje su preživele posle terapije. MRD dijagnostika predstavlja najosetljiviji metod za procenu odgovora na lečenje i najjači prognostički faktor kod ALL bolesnika. Detekcija MRD-a se najčešće zasniva na PCR analizi rearanžmana gena imunoglobulinskog teškog lanca (IGH) ili T-ćelijskog receptora (TCR) u uzorcima kostne srži (BM). Budući da je uzorkovanje BM invazivno i traumatično, cilj ove studije bio je procena kliničke korisnosti MRD monitoringa u perifernoj krvi (PB). Studija je obuhvatila 59 pacijenata sa ALL (44 B-ALL i 15 T-ALL). Uzorci PB i BM su uzeti nakon indukcione terapije i tokom praćenja. Testiranje klonalnosti je zasnovano na PCR analizama rearanžiranih IGH ili TCR gama gena. Kod pacijenata sa B-ALL, MRD je detektovana u BM kod 10 pacijenata i u PB kod 6 pacijenata. Kod T-ALL, MRD je detektovana u BM kod 7 pacijenata, a u PB kod 6 pacijenata. Dobijeni rezultati pokazuju da je kod pacijenata sa B-ALL procena MRD u BM više informativna nego analiza PB, dok se kod T-ALL traumatično uzorkovanje iz BM može zameniti analizom PB.

 

 

Ključne reči:

minimalna rezidualna bolest (MRD), akutna limfoblastna leukemija (ALL), kostna srž (BM)

 

 

References

 

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PDF Kozić Z. et al • MD-Medical Data 2017;9(4): 219-222

 

 

 

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