Department of Pediatric Hematology and Oncology, Nicolaus Copernicus University, Bydgoszcz, Poland.
Anticancer Res. 2011 Apr;31(4):1453-7.
The predictive value of residual disease measured by flow cytometry at day 15 of induction therapy was analyzed in 182 children treated for acute lymphoblastic leukemia (ALL).
Peripheral blood (PB) and bone marrow were assessed for leukemia cells by morphology and flow cytometry at days 0, 8, and 15.
Absolute blast count (ABC) >200/μl in PB by day 15 assessed by flow cytometry predicted a lower probability of disease free survival (pDFS) (p=0.056). Patients with bone marrow lymphoblast (BML)>0.5% had a lower pDFS (p=0.002). Cumulative relapse incidence for patients with BML<0.5% was 8.9% vs. 47.1% (OR=4.6, p=0.036). In common/pre-B-ALL patients aged >10 years with BML>0.5%, pDFS value was significantly lower. In the multivariate analysis, the only significant factor with adverse prognostic value for pDFS was BML>0.5% (HR=5.3 p=0.030).
BML>0.5% analyzed by flow cytometry at day 15 is possibly the strongest prognostic factor in pediatric ALL.
分析 182 例接受急性淋巴细胞白血病（ALL）治疗的儿童在诱导治疗第 15 天通过流式细胞术测量的残留疾病的预测价值。
在第 0、8 和 15 天通过形态学和流式细胞术评估外周血（PB）和骨髓中的白血病细胞。
通过流式细胞术评估 PB 中第 15 天的绝对白血病细胞计数（ABC）>200/μl 预测无疾病生存（pDFS）的可能性较低（p=0.056）。骨髓淋巴母细胞（BML）>0.5%的患者 pDFS 较低（p=0.002）。BML<0.5%的患者累积复发发生率为 8.9%，而 BML>0.5%的患者为 47.1%（OR=4.6，p=0.036）。在 BML>0.5%的>10 岁的常见/前 B-ALL 患者中，pDFS 值明显较低。在多变量分析中，唯一对 pDFS 有不良预后价值的显著因素是 BML>0.5%（HR=5.3，p=0.030）。
在第 15 天通过流式细胞术分析的 BML>0.5%可能是儿科 ALL 中最强的预后因素。
