A practical strategy of monitoring minimal residue disease and intervention for central nervous system relapse of childhood acute lymphoblastic leukemia: a single Chinese center's experience

J Pediatr Hematol Oncol. 2013 Jul;35(5):388-93. doi: 10.1097/MPH.0b013e31829084eb.

Abstract

Objective: To investigate monitoring minimal residual disease (MRD) using cerebral spinal fluid for predicting central nervous system leukemia (CNSL) and treatment.

Observations: There is no survival difference between enhanced triple intrathecal therapy (ETIT) and cranial radiation for CNSL patients with positive morphology and MRD. Positive MRD correlated with CNSL, whereas negative MRD indicated a lower chance of CNSL recurrence. Altogether 79 cerebral spinal fluid specimens indicating negative morphology but positive MRD were given either ETIT or conventional triple intrathecal therapy. The ETIT group indicated lower relapse.

Conclusion: Flow cytometry is sensitive to predict CNSL and ETIT is a potent intervention.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Central Nervous System Neoplasms / cerebrospinal fluid*
  • Central Nervous System Neoplasms / diagnosis
  • Central Nervous System Neoplasms / drug therapy
  • Child
  • Child, Preschool
  • China
  • Female
  • Flow Cytometry
  • Humans
  • Immunophenotyping
  • Kaplan-Meier Estimate
  • Male
  • Neoplasm Recurrence, Local / cerebrospinal fluid*
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm, Residual / cerebrospinal fluid*
  • Neoplasm, Residual / diagnosis
  • Neoplasm, Residual / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / cerebrospinal fluid*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Proportional Hazards Models