Detection of Minimal Residual Disease and Its Clinical Application for Childhood Leukemia
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概要
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More than 10<SUP>12</SUP> tumor cells are present in a leukemia patient at diagnosis. They decrease in number along with the chemotherapy and become undetectable by a microscope. Since the 80's several methods have been invented to visualize the existence of minimal residual disease (MRD). The most useful MRD assays currently available are polymerase chain reaction (PCR) amplification of fusion transcripts and rearranged T-cell receptor and immunoglobulin genes, and flow cytometric (FCM) detection of aberrant immunophenotypes. Both PCR and FCM methods allow detection of 1 leukemic cell in 10, 000 normal cells in at least 90% of patients with acute lymphoblastic leukemia. A number of clinical studies have elucidated that MRD assays are increasingly important in the clinical management of patients with acute leukemia. Several studies in children and adult patients with acute lymphoblastic leukemia and acute myeloid leukemia have shown a strong association between MRD and risk of relapse, irrespective of the methodology used to detect residual disease. Those who are positive for bone marrow MRD have a bad prognosis either after a standard protocol or the salvage therapy and stem cell transplantation for relapsed patients. These findings lead to the idea of modifying the therapeutic regimen according to the amount of MRD. The international BFM group in Europe and Japanese Children's Cancer and Leukemia Study Group (CCLSG) have started MRD-based protocol for ALL children.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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