Comparing morphology, flow cytometry and molecular genetics in the assessment of minimal residual disease in children with B-acute lymphoblastic leukaemia (B-ALL)

SA Journal of Oncology

Field Value
Title Comparing morphology, flow cytometry and molecular genetics in the assessment of minimal residual disease in children with B-acute lymphoblastic leukaemia (B-ALL)
Creator Hendricks, Candice L. Buldeo, Suvarna Pillay, Dashini Naidoo, Ashendran Thejpal, Rajendra Rapiti, Nadine Neethling, Beverley Goga, Yasmin van Staaden, Hamida
Subject clinical haematology; paediatric haematology minimal residual disease; B-acute lymphoblastic leukaemia; paediatric; flow cytometry; molecular genetics
Description ackground:Minimal residual disease (MRD) detection has been shown to be the best prognostic factor in B-acute lymphoblastic leukaemia (B-ALL). Multicolour flow cytometry (FCM) and specific molecular aberrations (MOL) are the classic techniques used to assess MRD. The former is faster and less costly.Aim: This study compares morphology and FCM to MOL in detecting MRD.Setting: The study was conducted at Inkosi Albert Luthuli Central Hospital (IALCH).Methods: A retrospective review of children with B-ALL managed at IALCH from January 2013 to January 2018 was conducted. Multicolour flow cytometry was performed using Euroflow® panels. Molecular aberrations looked at common cytogenetic markers. Presentation and post-induction morphology (May–Grunwald Giemsa stain), FCM and MOL data for MRD were analysed.Results: Eleven patients were excluded (6-demised, 5-incomplete records), leaving 64 to be analysed (54% female, median age 5 years). Five post-induction aspirates were unsuitable but the rest (92%) were in morphological remission. At diagnosis and post-induction, 62 (95%) and 61 (94%) children, respectively, had FCM performed. A positive MOL result was found in 39 (60%) patients. MOL turn-around times (TATs) averaged 14 days compared with those of FCM’s average of 3 days. MRD was found in 9 patients (FCM) and 7 patients (MOL). Of these patients, 4 had a good correlation between the two and 2 patients with negative FCM had positive MOL MRD post-induction.Conclusion: Morphology is insensitive in MRD assessment. FCM correlated well with molecular MRD and has the shortest turn-around time. FCM has major benefit in the 40% of patients with negative MOL. It can also be safely used to guide treatment escalation in those patients awaiting molecular results.
Publisher AOSIS
Contributor Nil
Date 2019-10-23
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective Review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajo.v3i0.76
Source South African Journal of Oncology; Vol 3 (2019); 8 pages 2523-0646 2518-8704
Language eng
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Coverage South Africa; KwaZulu Natal January 2013 - January 2018 children from 0-13 years; diagnosis of B-ALL
Rights Copyright (c) 2019 Candice L. Hendricks, Suvarna Buldeo, Dashini Pillay, Ashendran Naidoo, Rajendra Thejpal, Nadine Rapiti, Beverley Neethling, Yasmin Goga, Hamida van Staaden