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Prognostic influence of minimal residual disease detected by flow cytometry and peripheral blood stem cell transplantation by CD34 + selection in childhood advanced neuroblastoma
Author(s) -
Cai JiaoYang,
Tang YanJing,
Jiang LiMin,
Pan Ci,
Chen Jing,
Tang JingYan
Publication year - 2007
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21253
Subject(s) - medicine , minimal residual disease , cd34 , transplantation , flow cytometry , neuroblastoma , oncology , stem cell , bone marrow , hematopoietic stem cell transplantation , chemotherapy , gastroenterology , immunology , biology , cell culture , genetics
Objective To determine whether neuroblastoma (NB) minimal residual disease (MRD) in bone marrow (BM) detected by flow cytometry could predict prognosis and whether tumor cell purging by CD34 + cell selection prior to transplantation will impact on disease‐free survival. Methods NB MRD in BM was evaluated by flow cytometry with CD45‐FITC‐/CD81‐PE+/CD56‐PECy5+ monoclonal antibodies cocktail. Peripheral blood stem cell (PBSC) was enriched via positive CD34 + cell selection by magnetic‐activated cell separation system (MACS). Results Eleven of 31 patients with CD45 − /CD81+/CD56+ cells by flow cytometry at diagnosis became negative after an average of four courses of chemotherapy. All 11 patients remained alive without evidence of disease. Thirteen of the 20 patients with positive MRD relapsed and 1 patient died from disease (mean 25.8 months). There was a significant difference between these two groups. MRD in BM was tested before PBSC transplantation (PBSCT) for 19 NB patients. Fourteen was negative, 4 of them relapsed and 10 patients remained alive without evidence of disease. Another 5 patients with positive MRD, all of them relapsed (mean 17 months after PBSCT) with a significant difference between these two groups. Fourteen of 19 PBSC were purged with CD34 + selection procedure. Six of 14 relapsed (mean 18.43 months after PBSCT). Five patients did not purge for CD34 + selection, and 3 of them relapsed with no significant difference between these two groups. Conclusions Positive MRD in BM after an average of four courses of chemotherapy and before PBSCT is an unfavorable factor for stage IV NB. CD34 + selection purging for PBSCT may not improve the prognosis for children with neuroblastoma in advanced stage. Pediatr Blood Cancer 2007;49:952–957. © 2007 Wiley‐Liss, Inc.