LEUI(EMIA IN ACUTE CHILDHOOD MINIMAL REI/DUAL DISEASE

Abstract

The present study was conducted on 33 child diagnosed with acute childhood leukemia at SJCRH in Memphis, Tennessee, and POG multi-institutions trial for acute promyelocytic leukemia in the Unites States. Patients were selected based on the availability of cryopreserved bone marrow aspirate samples.

Twenty were males and 13 were females, with ages ranged from 2.3 to 17 years.

All enrolled patients had bone marrow aspirate and /or biopsy, cytogenetics, immunophenotyping, and molecular testing for the specific fusion genes at time of diagnosis.

Patients were divided into 3 group based on the diagnostic bone marrow, immunophenotyping, and molecular testing.

MRD monitoring was done using RT-PCR to target the characteristic fusion gene (TEL/AML1, PML/ RARA, and AML1/ ETO) found at diagnosis in each group.

The 1st group was a cohort of 13 patients with ALL expressing the TEL/AML1 fusion transcript. In this group the data showed that patients with TEL/AML1 ALL, had exquisite sensitivity to chemotherapy using 6-drug induction protocol with Vincristine, Prednisone, L-asparaginase, Ara-C, VP16, and Daunorubicin. All 13 patients tested at the end of induction therapy as well as follow up samples for 7 patients were negative for MRD using RT-PCR with a reproducible sensitivity of one malignant cell in 105 normal marrow cells.