In:
Pediatric Blood & Cancer, Wiley, Vol. 63, No. 11 ( 2016-11), p. 1935-1942
Kurzfassung:
Central nervous system (CNS) involvement is associated with relapse in childhood acute lymphoblastic leukemia (ALL) and is a diagnostic challenge. Procedure In a Nordic/Baltic prospective study, we assessed centralized flow cytometry (FCM) of locally fixed cerebrospinal fluid (CSF) samples versus local conventional cytospin‐based cytology (CC) for detecting leukemic cells and evaluating kinetics of elimination of leukemic cells in CSF. Results Among 300 patients with newly diagnosed ALL, 87 (29%) had CSF involvement by FCM, while CC was positive in 30 (10%) of 299 patients with available CC data ( P 〈 0.001). Patients with FCM+/CC+ had higher CSF leukemic blast counts compared to patients positive by FCM only (medians: 0.10 vs. 0.017 leukemic blasts/μl, P = 0.006). Patients positive by FCM had higher white blood cell counts in peripheral blood than patients negative by FCM (medians: 45 × 10 9 /l vs. 10 × 10 9 /l, P 〈 0.001), were younger (medians: 3 years vs. 4 years, P = 0.03), and more frequently had T‐cell ALL (18/87 vs. 16/213, P = 0.001). At treatment day 15, five of 52 patients (10%) who had CSF positive by FCM at diagnosis remained so despite at least two doses of weekly intrathecal chemotherapy. Conclusions Longer follow‐up is needed to clarify whether FCM positivity has prognostic significance and is an indicator for intensified CNS‐directed therapy.
Materialart:
Online-Ressource
ISSN:
1545-5009
,
1545-5017
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2016
ZDB Id:
2130978-4