Evaluation of Minimal Residual Disease (MRD) in Children with B-Cell Acute Lymphoblastic Leukemia During Maintenance of Remission

  • J. Peregud-Pogorzelski
  • J. Lubinski
  • A. Brodkiewicz
  • A. Jakubowska
  • V. Swiatkiewicz
  • A. Kurylak
Conference paper
Part of the Haematology and Blood Transfusion Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 41)


Application of molecular biology techniques in investigations of acute lymphoblastic leukemia contributed to better understanding of leukemic transformation mechanisms and allowed more accurate evaluation of treatment efficacy. The idea of residual malignant cells (MRD) has been introduced in order to evaluate more accurately the real number of circulating leukemic cells and to improve the methods of treatment and survival rates [7]. Monoclonal rearrangements of IgH and TCR genes are unique features of the given leukemic clone which allows monitoring of minimal residual disease (MRD) using the method of polymerase chain reaction (PCR). The rearrangements of IgH gene may be used in monitoring of residual leukemic cells in most cases of B-cell acute lymphoblastic leukemia. Majority of MRD studies in ALL were performed exclusively in children [1, 3, 4, 5, 9, 12, 13, 15, 17, 18, 19, 21, 22]. Elimination of residual leukemic cells confirmed by negative results of PCR test may predict long -term event- free survivals [14]. Many reports underline that positive PCR result frequently predicts relapse; however, it should be emphasized, that the result depends mainly on frequency and timing of the studies. The positive PCR results are also associated mainly with the medullary relapse [9,12,15, 17,18,19,22]. It is suggested that quantitative evaluation of MRD is more important than positive result found in a single investigation [16,17]. Some authors believe that evaluation of MRD at the end of the treatment constitute a valuable test for identifying patients likely to relapse [5,6, 13,18]. Other authors underline the lack of predictive value of that test in every single time point, thus indicating the need for serial semi — quantitative studies [16,17].


Acute Lymphoblastic Leukemia Minimal Residual Disease Childhood Acute Lymphoblastic Leukemia Positive Polymerase Chain Reaction Result Residual Leukemic Cell 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • J. Peregud-Pogorzelski
    • 1
  • J. Lubinski
    • 1
  • A. Brodkiewicz
    • 1
  • A. Jakubowska
    • 1
  • V. Swiatkiewicz
    • 2
  • A. Kurylak
    • 2
  1. 1.Department of Paediatrics, Department of Genetics and PathomorphologyPomeranian Academy of MedicineSzczecinPoland
  2. 2.Department of Paediatrics, Haematology and OncologyMedical UniversityBydgoszczPoland

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