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Flow cytometric detection of leukemic blasts in cerebrospinal fluid predicts risk of relapse in childhood acute lymphoblastic leukemia : a Nordic Society of Pediatric Hematology and Oncology study

Thastrup, Maria (author)
Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark.
Marquart, Hanne Vibeke (author)
Univ Copenhagen, Rigshosp, Dept Clin Immunol, Copenhagen, Denmark.
Levinsen, Mette (author)
Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark.
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Grell, Kathrine (author)
Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark.;Univ Copenhagen, Dept Publ Hlth, Sect Biostat, Copenhagen, Denmark.
Abrahamsson, Jonas (author)
Sahlgrens Univ Hosp, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
Albertsen, Birgitte Klug (author)
Aarhus Univ Hosp, Children & Adolescent Hlth, Aarhus, Denmark.
Frandsen, Thomas Leth (author)
Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark.
Harila-Saari, Arja H. (author)
Uppsala universitet,Barnneurologi/Barnonkologi
Lähteenmäki, Päivi Maria (author)
Turku Univ Hosp, Dept Pediat & Adolescent Med, Turku, Finland.;Turku Univ, Turku, Finland.
Niinimäki, Riitta (author)
Univ Oulu, Oulu Univ Hosp, Dept Pediat, Oulu, Finland.;Univ Oulu, PEDEGO Res Unit, Oulu, Finland.
Pronk, Cornelis Jan (author)
Skane Univ Hosp, Dept Pediat, Lund, Sweden.
Ulvmoen, Aina (author)
Oslo Univ Hosp, Dept Pediat, Oslo, Norway.
Vaitkeviciene, Goda (author)
Vilnius Univ Hosp Santaros Klinikos, Childrens Hosp, Ctr Pediat Oncol & Hematol, Vilnius, Lithuania.;Vilnius Univ, Vilnius, Lithuania.
Taskinen, Mervi (author)
Helsinki Univ Hosp, Div Pediat Hematol Oncol & Stem Cell Transplantat, Helsinki, Finland.
Schmiegelow, Kjeld (author)
Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark.;Univ Copenhagen, Fac Hlth & Med Sci, Inst Clin Med, Copenhagen, Denmark.
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Univ Copenhagen, Rigshosp, Dept Pediat & Adolescent Med, Copenhagen, Denmark Univ Copenhagen, Rigshosp, Dept Clin Immunol, Copenhagen, Denmark. (creator_code:org_t)
2019-09-18
2020
English.
In: Leukemia. - : Springer Nature. - 0887-6924 .- 1476-5551. ; 34:2, s. 336-346
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https://doi.org/10.1...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Central nervous system (CNS) involvement by cytospin is associated with increased risk of relapse in childhood acute lymphoblastic leukemia. We investigated if flow cytometric analysis of cerebrospinal fluid (CSF) at diagnosis improves the prediction of relapse. This prospective cohort study included patients (1.0-17.9 years) treated according to the Nordic Society of Pediatric Hematology and Oncology ALL2008 protocol. CSF flow cytometry samples were obtained at 17 centers, preserved with Transfix (R), and analyzed at a central laboratory. One-hundred and seventy-one (25.4%) of 673 patients were positive by flow cytometry (CNSflow+). The 4-year cumulative incidence of relapse was higher for patients with cytospin positivity (CNScyto+) (17.1% vs. 7.5%), CNSflow+ (16.5% vs. 5.6%), and cytospin and/or flow positivity (CNScomb+) (16.7% vs. 5.1%). In Cox regression analysis stratified by immunophenotype and minimal residual disease day 29 and adjusted by sex, predictors of relapse were age (hazard ratio [HR] 1.1, 95% CI 1.1-1.2, P < 0.001), white blood cell count at diagnosis (HR 1.4, 95% CI 1.1-1.6, P < 0.001), and CNScomb+ (HR 2.2, 95% CI 1.0-4.7, P = 0.042). Flow cytometric analysis of CSF improves detection of CNS leukemia, distinguishes patients with high and low risk of relapse, and may improve future risk stratification and CNS-directed therapy.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

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