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Childhood ALL

Flow cytometry and allele-specific oligonucleotide PCR are equally effective in detection of minimal residual disease in ALL

Leukemia volume 15, pages 716–727 (2001)Cite this article

Abstract

The analysis of minimal residual disease (MRD) has assumed a growing role in the follow-up of patients with acute lymphoblastic leukemia (ALL). We have applied multiparameter flow cytometry (FC) with ‘live-gate’ analysis and allele-specific oligonucleotide (ASO)-PCR detecting leukemia-specific T cell receptor γ and δ gene rearrangements for MRD follow-up in 30 ALL patients. The comparison of results obtained in 89 follow-up samples from 23 patients showed significantly consistent results in 70 samples (78%); (P < 0.001). Bone marrow samples taken during the first phase of treatment (during or immediately after induction) showed a lower level of consistency when compared to samples taken during later phases of treatment (69% vs 85% consistent results, respectively). Some of the discrepant results were due to low cellularity of the samples obtained for FC and some due to the presence of PCR inhibitors. Of 29 patients evaluated at the end of the induction treatment, 18 (62%) had detectable levels of MRD and six of these patients suffered relapse. In all these patients MRD levels by FC increased preceding relapse. Our results suggest that FC offers a MRD detection tool that can be easily applied in clinical practice and is as informative as molecular methods.

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Acknowledgements

This study was supported by grants from Swedish Cancer Society (Cancerfonden), Swedish Childhood Cancer Society (Barncancerfonden) and Stockholm County Council. PP is a Research Fellow of the Swedish Medical Research Council. The excellent technical assistance of Ms Inger Bodin, Yrsa Bringensparr, Marianne Lagnefeldt, Britt Lundh, Shalah Tarahumi, and Margareta Waern is gratefully acknowledged. We thank Mr Lewis Edgel for the linguistic consultation. Cytogenetic studies were performed at Dept of Clinical Genetics, Karolinska Hospital.

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Author notes

  1. P Pisa

    Present address: Department of Oncology, Karolinska Hospital, Stockholm, Sweden

  2. M Malec and E Björklund: Contributed equally to this study. MM was responsible for molecular analyses and EB for flow cytometry studies

  3. J Mazur: On leave from Department of Epidemiology, Institute of Mother and Child Health, Warsaw, Poland

Authors and Affiliations

  1. Department of Pathology, Hematopathology Laboratory, Karolinska Hospital, Stockholm, Sweden

    M Malec, E Björklund, J Mazur & A Porwit-MacDonald

  2. Division of Hematology, Department of Medicine, Karolinska Institutet at Karolinska Hospital, Stockholm, Sweden

    M Malec, A-M Sjögren, P Pisa & M Björkholm

  3. Childhood Cancer Research Unit, Astrid Lindgren's Child Hospital, Stockholm, Sweden

    S Söderhäll

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Malec, M., Björklund, E., Söderhäll, S. et al. Flow cytometry and allele-specific oligonucleotide PCR are equally effective in detection of minimal residual disease in ALL. Leukemia 15, 716–727 (2001). https://doi.org/10.1038/sj.leu.2402091

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