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Population-based study of the pattern of molecular markers of minimal residual disease in childhood and adult acute lymphoblastic leukemia: An assessment of the practical difficulty of representative sampling for trial purposes

Lookup NU author(s): Dr Peter Middleton, Jean Norden, Diana Levett, Dr Mark Levasseur, Professor Julie Irving, Dr Michael Reid, Dr Penelope Taylor, Professor Stephen Proctor


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Background. The prevalence, in unselected patients with acute lymphoblastic leukaemia (ALL), of clonal rearrangements suitable for minimal residual disease (MRD) studies has not been formally investigated. Procedure. This was a prospective, demographic study of the frequency of molecular markers of MRD in all patients with ALL presenting over 5 years within the Northern Health Region of England (population 3.1 million). Presentation marrow samples were examined to detect informative markers. Results. One hundred twenty-four children (age <15 years) developed non-Burkitt ALL. No material was available for study in 21. Eighty-six had clonal gene rearrangements (BCR/ABL, immunoglobulin heavy chain (IGH) and/or T cell receptor (TCR) gene rearrangements). All entered remission; 84 (68% of the original cohort) survived to become eligible for MRD studies. One hundred sixteen adults developed ALL, of whom 48 were not studied due to insufficient cellular material in the bone marrow aspirate or to logistical problems in central referral of samples from other hospitals. Material from elderly adults (age >55 years) was less likely to be sent for analysis, 36% vs. 59% (P = 0.024). Thirty-eight had BCR/ABL and/or IGH/TCR gene rearrangements. Thirty-one (27% of the original cohort) entered remission and became eligible for MRD studies. Informative gene rearrangements were more common in children than adults (83% vs. 63%, P < 0.003). Conclusions. The results reveal substantial potential, unintentional, selection bias. Largescale multicentre studies of MRD in children may well produce clinically relevant and representative data. Those who mount similar studies in adults should not assume they will be similarly representative or as successful in accrual of material. (C) 2000 Wiley-Liss, Inc.

Publication metadata

Author(s): Middleton PG, Norden J, Levett DL, Levasseur M, Miller S, Irving JAE, Wood A, Reid MM, Taylor PRA, Proctor SJ

Publication type: Article

Publication status: Published

Journal: Medical and Pediatric Oncology

Year: 2000

Volume: 34

Issue: 2

Pages: 106-110

Print publication date: 01/02/2000

ISSN (print): 0098-1532

ISSN (electronic):


DOI: 10.1002/(SICI)1096-911X(200002)34:2<106::AID-MPO6>3.0.CO;2-L

PubMed id: 10657870


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