Agarwal Aditi, Rana Deepshikha, More Shilpi, Sikka Meera, Dewan Pooja, Kotru Mrinalini
Pathology, University College of Medical Sciences, New Delhi, IND.
Pediatrics, University College of Medical Sciences, New Delhi, IND.
Cureus. 2024 Nov 4;16(11):e72968. doi: 10.7759/cureus.72968. eCollection 2024 Nov.
Background B-cell acute lymphoblastic leukemia (B-ALL) is one of the most common childhood malignancies and comprises almost the majority of acute leukemias in children. At the end of induction, minimal residual disease (MRD) is one of the most important prognostic indicators. MRD is commonly detected by multiparametric flow cytometry. Interpreting panels consisting of multiple tubes requires a lot of expertise and is subject to stringent standardization processes. Hence, there arises a need for an easier alternative that can be more universally applicable and reduce complexity in interpretation, resulting in uniform reporting and cost-effectiveness, especially in resource-deficient settings, without compromising clinical outcomes. Therefore, the aim is to find the usefulness of the MRD "lite" panel for post-induction MRD detection in pediatric B-ALL using CD38, CD10, CD34, CD19, and CD45 compared to the "standard tube" panel. Methods The study included 25 children diagnosed with B-ALL and undergoing treatment. MRD detection was performed on day 28 of post-induction chemotherapy using a standard tube panel consisting of three tubes (gold standard) and our single tube MRD "lite" panel. The results obtained by the two were compared. Results The sensitivity and specificity of the MRD "lite" panel were calculated as 100% and 84.2%, respectively, taking the standard tube panel as the gold standard. CD10, CD20, and CD200 were valuable in distinguishing MRD-positive cases from MRD-negative cases. Moreover, the MRD "lite" panel had 100% concordance between the two observers, suggesting simplicity in assessment and, hence, wider applicability.
背景 B细胞急性淋巴细胞白血病（B-ALL）是儿童最常见的恶性肿瘤之一，几乎占儿童急性白血病的大多数。诱导治疗结束时，微小残留病（MRD）是最重要的预后指标之一。MRD通常通过多参数流式细胞术检测。解读由多个管组成的检测板需要很多专业知识，并且要经过严格的标准化流程。因此，需要一种更简便的替代方法，这种方法可以更广泛地应用并降低解读的复杂性，从而实现统一报告并具有成本效益，尤其是在资源匮乏的环境中，同时又不影响临床结果。因此，本研究旨在比较MRD“精简版”检测板（使用CD38、CD10、CD34、CD19和CD45）与“标准管”检测板在儿童B-ALL诱导治疗后MRD检测中的实用性。方法 本研究纳入了25名诊断为B-ALL并正在接受治疗的儿童。在诱导化疗后第28天，使用由三个管组成的标准管检测板（金标准）和我们的单管MRD“精简版”检测板进行MRD检测。比较两者获得的结果。结果 以标准管检测板为金标准，MRD“精简版”检测板的敏感性和特异性分别计算为100%和84.2%。CD10、CD20和CD200在区分MRD阳性病例和MRD阴性病例方面很有价值。此外，MRD“精简版”检测板在两名观察者之间的一致性为100%，表明评估简单，因此适用性更广。
