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Minimal residual di...
Minimal residual disease quantification by flow cytometry provides reliable risk stratification in T-cell acute lymphoblastic leukemia
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Modvig, S (author)
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- Madsen, H O (author)
- Umeå universitet,Patologi
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- Marincevic, Millaray, 1983- (author)
- Uppsala universitet,Klinisk och experimentell patologi,Rose-Marie Amini
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Rosthøj, S (author)
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Tierens, A (author)
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Juvonen, V (author)
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Osnes, L T N (author)
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Vålerhaugen, H (author)
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Hultdin, M (author)
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- Thörn, Ingrid, 1957- (author)
- Uppsala universitet,Klinisk och experimentell patologi,Rose-Marie Amini
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Matuzeviciene, R (author)
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Stoskus, M (author)
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- Marincevic, Millaray, 1983- (author)
- Uppsala universitet,Klinisk och experimentell patologi,Rose-Marie Amini
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Fogelstrand, L (author)
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Lilleorg, A (author)
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Toft, N (author)
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Jónsson, O G (author)
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Pruunsild, K (author)
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Vaitkeviciene, G (author)
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Vettenranta, K (author)
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Lund, B (author)
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Abrahamsson, J (author)
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Schmiegelow, K (author)
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Marquart, H V (author)
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(creator_code:org_t)
- 2018-12-14
- 2019
- English.
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In: Leukemia. - : Nature Publishing Group. - 0887-6924 .- 1476-5551. ; 33:6, s. 1324-1336
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https://www.nature.c...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
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- Minimal residual disease (MRD) measured by PCR of clonal IgH/TCR rearrangements predicts relapse in T-cell acute lymphoblastic leukemia (T-ALL) and serves as risk stratification tool. Since 10% of patients have no suitable PCR-marker, we evaluated flowcytometry (FCM)-based MRD for risk stratification. We included 274 T-ALL patients treated in the NOPHO-ALL2008 protocol. MRD was measured by six-color FCM and real-time quantitative PCR. Day 29 PCR-MRD (cut-off 10-3) was used for risk stratification. At diagnosis, 93% had an FCM-marker for MRD monitoring, 84% a PCR-marker, and 99.3% (272/274) had a marker when combining the two. Adjusted for age and WBC, the hazard ratio for relapse was 3.55 (95% CI 1.4-9.0, p = 0.008) for day 29 FCM-MRD ≥ 10-3 and 5.6 (95% CI 2.0-16, p = 0.001) for PCR-MRD ≥ 10-3 compared with MRD < 10-3. Patients stratified to intermediate-risk therapy on day 29 with MRD 10-4-<10-3 had a 5-year event-free survival similar to intermediate-risk patients with MRD < 10-4 or undetectable, regardless of method for monitoring. Patients with day 15 FCM-MRD < 10-4 had a cumulative incidence of relapse of 2.3% (95% CI 0-6.8, n = 59). Thus, FCM-MRD allows early identification of patients eligible for reduced intensity therapy, but this needs further studies. In conclusion, FCM-MRD provides reliable risk prediction for T-ALL and can be used for stratification when no PCR-marker is available.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Klinisk laboratoriemedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Clinical Laboratory Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- Patologi
- Pathology
Publication and Content Type
- ref (subject category)
- art (subject category)
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Leukemia
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- By the author/editor
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Modvig, S
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Madsen, H O
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Marincevic, Mill ...
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Rosthøj, S
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Tierens, A
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Juvonen, V
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show more...
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Osnes, L T N
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Vålerhaugen, H
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Hultdin, M
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Thörn, Ingrid, 1 ...
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Matuzeviciene, R
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Stoskus, M
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Fogelstrand, L
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Lilleorg, A
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Toft, N
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Jónsson, O G
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Pruunsild, K
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Vaitkeviciene, G
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Vettenranta, K
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Lund, B
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Abrahamsson, J
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Schmiegelow, K
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Marquart, H V
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Clinical Laborat ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
- Articles in the publication
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Leukemia
- By the university
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Uppsala University
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Umeå University