This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Mandrell, B. N. Articles by Pritchard, M. Search for Related Content PubMed PubMed Citation Articles by Mandrell, B. N. Articles by Pritchard, M. Social Bookmarking                         What's this?

Understanding the Clinical Implications of Minimal Residual Disease in Childhood Leukemia

St. Jude-University of Pennsylvania Distance Learning Program; Department of Nursing Research, Mail Stop 0738, St. Jude Children's Research Hospital, 332 North Lauderdale Street, Memphis, TN 38105-2794 belinda.mandrell{at}stjude.org

Michele Pritchard, MSN, RN, PNP-C

Department of Hematology/Oncology at St. Jude Children's Research Hospital, Memphis, TN.

Improved laboratory techniques now allow a more sensitive detection of leukemia cells at designated intervals throughout therapy. Using flow cytometry and polymerase chain reaction, it is possible to detect 1 leukemic cell among 10 4 normal cells (1 leukemia cell in 10,000 normal cells), representing a 100-fold greater sensitivity than morphological examination in acute lymphoblastic leukemia (ALL). Recently, it has been shown that the molecular presence of persistent acute lymphoblastic leukemia at the end of remission therapy is a poor indicator of clinical outcome. Now similar studies are being performed in acute myeloid leukemia (AML). While the sensitivity using flow cytometry is less in AML than in ALL (able to detect 1 leukemic cell among 1000 normal cells in AML), persistent or minimal residual AML provides the clinician guidance with future treatment recommendations. Minimal residual disease (MRD) is now considered an important indicator response of disease response to treatment. As such, MRD once considered a research variable is now influencing treatment decisions. Therefore, it is imperative that the nurse have an understanding of the newer techniques to study residual leukemia and their clinical implications for patients and their families.

Key Words: minimal residual disease (MRD) • polymerase chain reaction • flow cytomery • cancer • child

References

• Arceci, R. J. (2002). Progress and controversies in the treatment of pediatric acute myelogenous leukemia. Current Opinion in Hematology, 9, 353-360.[CrossRef][Medline] [Order article via Infotrieve]
• Bader, P., Hancock, J., Kreyenberg, H., Goulden, N. J., Niethammer, D., Oakhill, A., et al. (2002). Minimal residual disease (MRD) status prior to allogeneic stem cell transplantation is a powerful predictor for post-transplant outcome in children with ALL. Leukemia, 16, 1668-1672.[CrossRef][Medline] [Order article via Infotrieve]
• Buonamici, S., Ottaviani, E., Testoni, N., Montefusco, V., Visani, G., Bonifazi, F., et al. (2002). Real-time quantitation of minimal residual disease in inv(16)-positive acute myeloid leukemia may indicate risk of clinical relapse and may identify patients in curable state. Blood, 99, 443-449.[Abstract/Free Full Text]
• Campana, D. (2003). Determination of minimal residual disease in leukaemia patients. British Journal of Haematology, 121, 823-838.[CrossRef][Medline] [Order article via Infotrieve]
• Campana, D., Neale, G. A., Coustan-Smith, E., & Pui, C.-H. (2001). Detection of minimal residual disease in acute lymphoblastic leukemia: The St. Jude experience. Leukemia, 15, 278-279.[CrossRef][Medline] [Order article via Infotrieve]
• Campana, D., Van Dongen, J. J. M., and Pui, C.-H. (1999). Minimal residual disease. Childhood leukemias. In C.-H. Pui (Ed.), Childhood leukemias(pp. 413-439). UK: Cambridge University Press.
• Cave, H., van der Werfften, B. J., Sucisu, S., Guidal, S., Waterkeyn, C., Bakkus, O. J., et al. (1998). Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia. New England Journal of Medicine, 339, 591-598.[Abstract/Free Full Text]
• Coustan-Smith, E., Gajjar, A., Hijiya, N., Razzouk, B. I., Ribeiro, R. C., Rivera, G. K., et al. (2004). Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. Leukemia, 18, 499-504.[CrossRef][Medline] [Order article via Infotrieve]
• Coustan-Smith, E., Ribeiro, R., Rubnitz, J., Razzouk, B., Pui, C.-H., Pounds, S., et al. (2003). Clinical significance of residual disease during treatment in childhood acute myeloid leukaemia. British Journal of Haematology, 123, 243-252.[CrossRef][Medline] [Order article via Infotrieve]
• Coustan-Smith, E., Sancho, J., Hancock, M. L., Boyeet, J. M., Behm, F. G., Raimondi, S. C., et al. (2000). Clinical manifestation of minimal residual disease in childhood acute lymphoblastic leukemia. Blood, 96, 2691-2696.[Abstract/Free Full Text]
• Diverio, D., Rossi, V., Avvisati, G., De Santis, S., Pistilli, A., Pane, F., et al. (1998). Early detection of relapse by prospective reverse transcriptase polymerase chain reaction analysis of the PML-RARa fusion gene in patients with acute promyelocytic leukemia enrolled in the GIMEMA-AIEOP multicentre "AIDA" trial. Blood, 92, 784-789.[Abstract/Free Full Text]
• Grimwade, D. (2002). The significance of minimal residual disease in patients with t(15;17). Bailliere's Best Practice Research and Clinical Haematology, 15, 137-158.
• Guerrasio, A., Pilantrino, C., DeMicheli, D., Cilloni, D., Serra, A., Gottardi, E., et al. (2002). Assessment of minimal residual disease (MRD) in CBFbeta/MYH11-positive acute myeloid leukemias by qualitative and quantitative RT-PCR amplification of fusion transcripts. Leukemia, 16, 1176-1181.[CrossRef][Medline] [Order article via Infotrieve]
• Jurlander, J., Caligiuri, M., Ruutu, T., Baer, M., Strout, M., Oberkircher, L., et al. (1996). Persistence of AML1-ETO fusion transcript in patients treated with allogeneic bone marrow transplantation for t(8:21) leukemia. Blood, 88, 2183-2191.[Abstract/Free Full Text]
• Laczika, K., Mitterbauer, G., Mitterbauer, M., Knobl, P., Schwarzinger, I., Greinix, H., et al. (2001). Prospective monitoring of minimal residual disease in acute myeloid leukemia with inversion (160 by CBFbeta/MYH11 RT-PCR: Implications for a monitoring schedule and for treatment decisions. Leukemia and Lymphoma, 42, 923-931.
• Liu, Y. J., & Grimwade, D. (2002). Minimal residual disease evaluation in acute myeloid leukemia. Lancet, 360, 160-162.[CrossRef][Medline] [Order article via Infotrieve]
• Marcucci, G., Caligiuri, M., Dohner, H., Archer, K., Schlenk, R., Dohner, K., et al. (2001). Quantification of CBFbeta-MYH11 fusion transcript by real time RT-PCR in patients with inv(16) acute myeloid leukemia. Leukemia, 15, 1072-1080.[CrossRef][Medline] [Order article via Infotrieve]
• Morschhauser, F., Cayuela, J., Martine, S., Baruchel, A., Rousselot, P., Socie, G., et al. (2000). Evaluation of minimal residual disease using reverse-transcriptase polymerase chain reaction t(8;21) acute myeloid leukemia: A multicenter study of 51 patients. Journal of Clinical Oncology, 18, 788-794.[Abstract/Free Full Text]
• Neale, G. A., Coustan-Smith, E., Pan, Q., Chen., X., Gruhn, B., Stow, P., et al. (1999). Tandem application of flow cytometry and polymerase chain reaction for comprehensive detection of minimal residual disease in childhood acute lymphoblastic leukemia. Leukemia, 13, 1221-1226.[CrossRef][Medline] [Order article via Infotrieve]
• Nucifora, G., Larson, R., & Rowley, J. (1993). Persistence of the (8;21) translocation in patients with acute myeloid leukemia type M-2 in long-term remission. Blood, 82, 712-715.[Abstract/Free Full Text]
• Pui, C.-H., & Campana, D. (2000). New definition in remission in childhood acute lymphoblastic leukemia. Leukemia, 14, 783-785.[CrossRef][Medline] [Order article via Infotrieve]
• Pui,C.-H., & Evans,W.E. (1998). Acute lymphoblastic leukemia. New England Journal of Medicine, 339, 605-615.[Free Full Text]
• San Miguel, J., Martinez, A., Macedo, A., Vidriales, M., Lopez-Berges, C., Gonzalez, M. et al. (1997). Immunophenotyping investigation of minimal residual disease is a useful approach for predicting relapse in acute myeloid patients. Blood, 90, 2465-2470.[Abstract/Free Full Text]
• San Miguel, J., Vidriales, M., Lopez-Berges, C., Diaz-Mediavilla, J., Gutierrez, N., Canizo, C., et al. (2001). Early immunophenotypical evaluation of minimal residual disease in acute myeloid leukemia identifies different patient risk groups and may contribute to postinduction treatment stratification. Blood, 98, 1746-1751.[Abstract/Free Full Text]
• Sievers, E., Lange, B., Alonzo, T., Gerbing, R., Bernstein, I., Smith, F., et al. (2003). Immunophenotypic evidence of leukemia after induction therapy predicts relapse: Results from a prospective children's cancer group study of 252 acute myeloid leukemia patients. Blood, 101, 3398-3406.[Abstract/Free Full Text]
• Sievers, E., Lange, B., Buckley, J., Smith, F., Wells, D., Daigneault-Creech, C., et al. (1996). Prediction of relapse of pediatric acute myeloid leukemia by use of multidimensional flow cytometry. Journal of the National Cancer Institute, 88, 1483-1488.[Abstract/Free Full Text]
• Tobal, K., Newton, J., Macheta, M., Chang, J., Morganstern, G., Evans, P., et al. (2000). Molecular quantitation of minimal residual disease in acute myeloid leukemia with t(8;21) can identify patients in durable remission and predict clinical relapse. Blood, 95, 815-819.[Abstract/Free Full Text]
• Venditti, A., Buccisano, F., Del Poeta, G., Maurillo, L., Tamburini, A., Cox, C., et al. (2000). Level of minimal residual disease after consolidation therapy predicts outcome in acute myeloid leukemia. Blood, 96, 3948-3952.[Abstract/Free Full Text]

Journal of Pediatric Oncology Nursing, Vol. 23, No. 1, 38-44 (2006)
DOI: 10.1177/1043454205284349


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				E. Marston, V. Weston, J. Jesson, E. Maina, C. McConville, A. Agathanggelou, A. Skowronska, K. Mapp, K. Sameith, J. E. Powell, et al. Stratification of pediatric ALL by in vitro cellular responses to DNA double-strand breaks provides insight into the molecular mechanisms underlying clinical response Blood, January 1, 2009; 113(1): 117 - 126. [Abstract] [Full Text] [PDF]

				M. Hou, M. Andersson, S. Eksborg, O. Soder, and K. Jahnukainen Xenotransplantation of testicular tissue into nude mice can be used for detecting leukemic cell contamination Hum. Reprod., July 1, 2007; 22(7): 1899 - 1906. [Abstract] [Full Text] [PDF]

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Mandrell, B. N. Articles by Pritchard, M. Search for Related Content PubMed PubMed Citation Articles by Mandrell, B. N. Articles by Pritchard, M. Social Bookmarking                         What's this?