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Acute lymphoblastic leukemia

Prognostic value of minimal residual disease measured by flow-cytometry in two cohorts of infants with acute lymphoblastic leukemia treated according to either MLL-Baby or Interfant protocols

Leukemia volume 34, pages 3042–3046 (2020)Cite this article

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Acute lymphoblastic leukemia (ALL) in infants is a relatively rare disease with peculiar biological features and worse outcome in comparison to ALL in older children [1,2,3]. With current protocols, event-free survival (EFS) in this subgroup of patients does not exceed 50% [3]. Large cooperative studies on infant ALL have been promoted by the Interfant consortium [3, 4] and MLL-Baby network [5] since 1999 and 2003, respectively.

Currently, minimal residual disease (MRD) monitoring by either polymerase chain reaction (PCR) or through multicolor flow-cytometry (MFC) is considered a fundamental tool for optimizing management of children with ALL [6,7,8,9]. The prognostic value of molecular MRD in infant ALL has been previously discussed in a limited number of studies [10, 11], although PCR techniques showed limitations in this age group, including possible oligoclonality and loss of targets during follow-up [12, 13]. Aim of our study was to evaluate the prognostic value of MFC MRD measurement during induction in infants with ALL treated with different approaches: MLL-Baby protocol in Russia and Belarus, as well as Interfant-99 and Interfant-06 protocols in AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) centers in Italy.

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Fig. 1: Event-free survival (EFS) and cumulative incidence of relapse (CIR) according to risk groups based on minimal residual disease (MRD) value evaluated on day-15 bone marrow samples, as detected by multicolor flow-cytometry (MFC).
Fig. 2: Event-free survival (EFS) and cumulative incidence of relapse (CIR) according to risk groups based on minimal residual disease (MRD) value evaluated at end of Induction, as detected by multicolor flow-cytometry (MFC).

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Acknowledgements

The authors thank first of all Alessandra Benetello for the great and passionate job she performed for the improvement of MRD detection. The work was supported by ICRETT fellowship of UICC. For AIEOP this work was supported by Fondazione Città della Speranza, Fondazione Cariparo, grant from MIUR (FIRB), grant from ENCCA-European Network for cancer Research in children/adolescent, MIUR/PRIN 2007-cofin Ateneo, MUR/PRIN 2007.

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  1. These authors contributed equally: Alexander Popov, Barbara Buldini

Authors and Affiliations

  1. National Research and Clinical Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation

    Alexander Popov, Natalia Miakova, Alexander Karachunskiy & Alexander Roumiantsev

  2. Dipartimento di Salute della Donna e del Bambino, University of Padua, Padua, Italy

    Barbara Buldini & Giuseppe Basso

  3. Interfant Trial Data Center, School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy

    Paola De Lorenzo & Maria Grazia Valsecchi

  4. Tettamanti Research Center, Pediatric Clinic, University of Milan-Bicocca, Fondazione MBBM/ S. Gerardo Hospital Monza, Monza, Italy

    Paola De Lorenzo & Andrea Biondi

  5. Fondazione Città della Speranza - Onlus, Dipartimento di Salute della Donna e del Bambino, University of Padova, Padova, Italy

    Silvia Disarò, Emanuela Giarin & Annamaria Di Meglio

  6. Regional Children Hospital, Ekaterinburg, Russian Federation

    Tatiana Verzhbitskaya, Grigory Tsaur & Larisa Fechina

  7. Research Institute of Medical Cell Technologies, Ekaterinburg, Russian Federation

    Tatiana Verzhbitskaya, Grigory Tsaur & Larisa Fechina

  8. Belarussian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus

    Liudmila Movchan & Olga Aleinikova

  9. PET-Technology Center of Nuclear Medicine, Ekaterinburg, Russian Federation

    Egor Shorikov

  10. Department of Pediatric Hemato-Oncology, Santobono-Pausilipon Hospital, Naples, Italy

    Rosanna Parasole

  11. City Children’s Hospital №1, Saint-Petersburg, Russian Federation

    Elmira Boichenko

  12. Morozov Children’s Hospital, Moscow, Russian Federation

    Konstantin Kondratchik

  13. Department of Pediatric Hematology and Oncology, Scientific Institute for Research and Healthcare (IRCCS), Bambino Gesù Children’s Hospital, Rome, Italy

    Franco Locatelli

  14. Sapienza, University of Rome, Rome, Italy

    Franco Locatelli

  15. Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands

    Rob Pieters

  16. Italian Institute for Genomic Medicine, Turin, Italy

    Giuseppe Basso

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  1. Alexander Popov
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Correspondence to Alexander Popov.

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Popov, A., Buldini, B., De Lorenzo, P. et al. Prognostic value of minimal residual disease measured by flow-cytometry in two cohorts of infants with acute lymphoblastic leukemia treated according to either MLL-Baby or Interfant protocols. Leukemia 34, 3042–3046 (2020). https://doi.org/10.1038/s41375-020-0912-z

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