[Role of three-color flow cytofluorometry in the algorithm for detection of minimal residual disease in children with acute lymphoblastic and acute myeloblastic leukemia].

Three-color flow cytofluorometry (FCF) was used to identify minimal residual disease in 124 patients with acute lymphoblastic leukemia (ALL) treated in accordance with the ALL-myeloblastic leukemia (MBL)-2002/2008 protocol and 36 patients with MBL treated under the MBL-MM-2000 protocol. It was shown that approximately a fifth of children with ALL, 3-color FCF could not monitor minimal residual disease, which required the use of 4- or more-color FCF and parallel determination in these MBL samples by molecular genetic methods. An algorithm of study of MBL by FCF, by additionally using molecular genetic methods, is presented.

Plasma level of tumor necrosis factor-alpha (TNF-alpha) correlates with leukocytosis and biological features of leukemic cells, but not treatment response of children with acute lymphoblastic leukemia.

We have analyzed the clinical significance of the plasma level of tumor necrosis-alpha (TNF-alpha) detection in childhood acute lymphoblastic leukemia (ALL) at diagnosis. 49 patients (pts) with B-lineage ALL (3-17 years of age) and 30 healthy children (age-related control) were enrolled in study. The mean value of the level of TNF-alpha was 43.4 +/- 8.1 pg/ml in ALL pts and 30.7 +/- 3 pg/ml in control. In ALL pts the level of TNF-alpha positively correlated with blast cell count in peripheral blood (R = +0.432; P = 0.008); negatively correlated with percentages of S-phase leukemic cells (R = -0.446; P = 0.042) and culture-induced apoptotic cells (R = -0.411; P = 0.057). Pts with TNF-alpha level above the median value were characterized by higher WBC count (P = 0.025), lower percentage of S-phase leukemic cells (P = 0.02) and tendency to lower percentage of apoptotic cells (P = 0.07) vs pts with TNF-alpha level below the median value. No significant association of the level of TNF-alpha with treatment response at days 8 and 15 or 3-year overall survival was defined. We conclude that the elevated plasma level of TNF-alpha is a useful marker to assess disease activity/progression, but not prognosis of childhood B-lineage ALL.