PCR detection of minimal residual disease in pediatric acute lymphoblastic leukemia

ABSTRACT

Over the last four decades acute lymphoblastic leukemia [ALL] of childhood has turned from a fatal to curable disease. Nevertheless, about 30% of children relapse after initial remission. Achievement of complete remission is an essential step in maintaining prolonged remission. Minimal residual disease [MRD] is usually present in most patients after completion of therapy, and multitude of techniques for its detection have been developed over the last decade. In the present study we optimized a PCR amplification of immunoglobulin heavy chain [IgH] gene rearrangements to investigate MRD in children with ALL at diagnosis and after remission. This technique seemed to be simple, reliable and more sensitive than other techniques. One year follow up of the patients after induction of remission, PCR showed a higher percentage of maintained remission among patients with negative PCR amplification of IgH gene rearrangements also provide reliable marker for relapse detection in B lineage ALL. These results will help to adopt more effective therapeutic protocols to achieve molecular remission rather than the morphological one used now a day