作者: J. Peregud-Pogorzelski , J. Lubinski , A. Brodkiewicz , A. Jakubowska , R. Debski
DOI: 10.1007/978-3-642-59358-1_55
关键词:
摘要: In acute leukemias malignant cells derived from the sole parent cell that underwent neoplastic transformation share identical configuration of Ig and TCR genes. Monoclonal rearrangements genes comprise unique features given leukemic clone, thus allowing basis for monitoring minimal residual disease (MRD) using polymerase chain reaction (PCR) method in lymphoblastic [1,4,7,14,22]. Results several clinical studies indicate detection ALL correlates positively with relapse [5,10,14,20, 21,22]. Acute T-cell leukemia is a clinically homogenous high rate treatment failures. Thus, immunophenotype considered as an unfavourable prognostic factor. Intensification group patients produced current results comparable those achieved non- T-ALL [14,15,16]. Occurrence reflects ineffectiveness chemotherapy allogenic bone marrow transplantation probably only chance cure. Ability to identify population at risk would allow early alternative treatment. context TCRδ TCRγ gene represent optimal target MRD PCR assay T-ALL, since least one allele rearranged 95% remains stable more than 90% cases [3], Also rearrangements, present 70% show limited potential variety, use procedures detect positive results, vast diversity junctional sites allows preparation patient- specific probes [2,3], Studies performed by Dibenedetto et al. showed might be detected test 12-15 weeks after completion induction therapy almost all (94%), regardless protocol [8]. Their analysis confirms observation presence 30-40 diagnosis predictor poor prognosis. On contrary, lack any time point correlated favourable this prospective study we investigated 18 childhood various points BFM 90 protocol. We applied previously described Vandenvelde Taylor [18,19]. The aim was answer question whether children influence outcome.