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首页> 外文期刊>Egyptian Journal of Medical Human Genetics >Clinical impact of early minimal residual disease detection at day 15 in precursor B-childhood acute lymphoblastic leukemia: an Egyptian experience
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Clinical impact of early minimal residual disease detection at day 15 in precursor B-childhood acute lymphoblastic leukemia: an Egyptian experience

机译：早期最小残留疾病检测的临床影响在第15天前体育急性淋巴细胞白血病：埃及经验

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Background:Chromosomal abnormalities in childhood acute lymphoblastic leukemia (ALL) are well-established prognostic markers and useful tools for minimal residual disease (MRD) assessment. This study aimed to stratify high-risk precursor B-childhood ALL (pre-B-ALL) patients according to standard prognostic factors (age and total leucocytic count), fluorescence in situ hybridization (FISH) analysis for these cytogenetic abnormalities [t (9;22) BCR/ABL, t(1;19)TCF3/PBX1, and 11q23 MLL gene rearrangement], and MRD status at day 15. Besides, we aimed to demonstrate the relation of these prognostic factors (standard and cytogenetic risk groups) to patients’ outcome at day 15 of induction therapy as well as exploring the impact of early MRD assessment during remission induction compared to other prognostic factors together with the ability to tailor investigations as needed especially in places with limited health resources without compromising the outcome. Seventy-two newly-diagnosed Egyptian children with pre-B-ALL, aged 6?months to 15.5?years, registered from February 2016 to February 2018 were included. They were treated according to the modified Children’s Oncology Group (COG) protocol. Patients were classified into (a) standard and high-risk groups according to standard prognostic factors. (b) Patients with the studied cytogenetic abnormalities and patients without the studied cytogenetic abnormalities. (c) Good outcome (negative MRD) and bad outcome (positive MRD) groups according to day 15 MRD status.ResultsThe studied cytogenetic abnormalities were identified in 22.2% of patients, all of them were in the high-risk group, and 75% of them had a bad outcome (positive MRD) at day 15 of induction therapy.ConclusionPatients with favorable presenting features (standard risk) and undetectable MRD after 2?weeks remission induction therapy would not be in need to advanced molecular studies, while these studies should be considered for patients with high-risk presenting features and high levels of MRD after 2?weeks remission induction therapy. Therefore, this could provide a cost-effective guideline in countries suffering from financial challenges without affecting the outcome.
机译：背景：儿童急性淋巴细胞白血病（ALL）的染色体异常是良好的预后标志物和用于最小残留疾病（MRD）评估的有用工具。本研究旨在根据标准预后因素（年龄和总白细胞计数），荧光原位杂交（鱼类）分析（鱼类）分析这些细胞遗传学异常[T（9; 22）BCR / ABL，T（1; 19）TCF3 / PBX1和11Q23 MLL基因重排]，以及第15天的MRD状态。此外，我们旨在证明这些预后因素的关系（标准和细胞遗传学风险群体）对诱导治疗第15天的患者的结果以及探讨缓解诱导期间早期MRD评估的影响与其他预后因素相比，以及根据需要定制调查的能力，尤其是健康有限的地方资源而不妥协结果。七十二名新诊断的埃及儿童预先B-全部，年龄在6岁以下的时间为15.5岁至15.5岁，于2016年2月至2018年2月注册。它们根据改性儿童肿瘤学群（COG）议定书进行治疗。根据标准的预后因素，患者分为（a）标准和高风险群体。 （b）患有研究的细胞遗传学异常和患者，没有学习的细胞遗传学异常。 （c）良好的结果（负MRD）和不良结果（阳性MRD）组根据第15天MRD状态。在22.2％的患者中发现了细胞遗传学异常，所有这些都在高风险组中，75％在诱导治疗的第15天具有糟糕的结果（阳性MRD）。在2次缓解诱导治疗后，具有良好的呈递特征（标准风险）和未检测到的MRD的结论韧性，而且这些研究应该在2次缓解诱导治疗后，被认为是高风险呈现特征和高水平MRD的患者。因此，这可以在不影响结果的情况下在遭受财务挑战的国家提供经济效益的指导。

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