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Detection and role of minimal disseminated disease in children with lymphoblastic lymphoma: The AIEOP experience
Author(s) -
Mussolin Lara,
Buldini Barbara,
Lovisa Federica,
Carraro Elisa,
Disarò Silvia,
Nigro Luca Lo,
d'Amore Emanuele S.G.,
Pillon Marta,
Basso Giuseppe
Publication year - 2015
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.25607
Subject(s) - medicine , lymphoblastic lymphoma , lymphoma , bone marrow , percentile , oncology , flow cytometry , immunology , t cell , statistics , immune system , mathematics
Background The use of intensive chemotherapy regimens in children with lymphoblastic lymphoma (LBL) has significantly improved outcome, but the salvage rate for these patients is still poor. The aim of this study was to evaluate the prognostic value of minimal disseminated disease (MDD), studied by multiparametric flow cytometry (MFC), in pediatric patients with T‐ and B‐lineage LBL. Procedure We examined bone marrow (BM) and peripheral blood (PB) samples from a series of 65 children affected by T‐ (52) and B‐lineage (13) LBL using an MFC method; 10 of them were also analyzed for clonality of T‐cell receptor gene rearrangements. Results MDD was detected in 49% (32/65) of BM samples, whereas only 21% (14/65) were positive at standard morphological evaluation. Findings from MFC analyses of paired BM and PB samples were highly concordant. We analyzed the prognostic significance of MDD results detected at diagnosis in morphologically negative patients, as almost all relapsed cases (10/11) did not have any morphological involvement of BM at diagnosis. Using an MDD cut‐off level of 3% by FCM (75th percentile), 5‐year event‐free survival (EFS) was 60% (SE ± 22) for patients with MDD >3% LBL cells versus 83% (SE ± 6) for the remaining patients ( P = 0.04). No statistically significant difference in EFS was observed between LBL patients considering all the other clinical characteristics. Conclusions Our data demonstrated that MDD studied at diagnosis by MFC could represent a useful prognostic tool in childhood LBL and further application for better stratification is warranted. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc.