Leukemic blasts are present at low levels in spinal fluid in one-third of childhood acute lymphoblastic leukemia cases
(2016) In Pediatric Blood & Cancer 63(11). p.1935-1942- Abstract
Background: Central nervous system (CNS) involvement is associated with relapse in childhood acute lymphoblastic leukemia (ALL) and is a diagnostic challenge. Procedure: In a Nordic/Baltic prospective study, we assessed centralized flow cytometry (FCM) of locally fixed cerebrospinal fluid (CSF) samples versus local conventional cytospin-based cytology (CC) for detecting leukemic cells and evaluating kinetics of elimination of leukemic cells in CSF. Results: Among 300 patients with newly diagnosed ALL, 87 (29%) had CSF involvement by FCM, while CC was positive in 30 (10%) of 299 patients with available CC data (P < 0.001). Patients with FCM+/CC+ had higher CSF leukemic blast counts compared to patients positive by FCM only (medians:... (More)
Background: Central nervous system (CNS) involvement is associated with relapse in childhood acute lymphoblastic leukemia (ALL) and is a diagnostic challenge. Procedure: In a Nordic/Baltic prospective study, we assessed centralized flow cytometry (FCM) of locally fixed cerebrospinal fluid (CSF) samples versus local conventional cytospin-based cytology (CC) for detecting leukemic cells and evaluating kinetics of elimination of leukemic cells in CSF. Results: Among 300 patients with newly diagnosed ALL, 87 (29%) had CSF involvement by FCM, while CC was positive in 30 (10%) of 299 patients with available CC data (P < 0.001). Patients with FCM+/CC+ had higher CSF leukemic blast counts compared to patients positive by FCM only (medians: 0.10 vs. 0.017 leukemic blasts/μl, P = 0.006). Patients positive by FCM had higher white blood cell counts in peripheral blood than patients negative by FCM (medians: 45 × 109/l vs. 10 × 109/l, P < 0.001), were younger (medians: 3 years vs. 4 years, P = 0.03), and more frequently had T-cell ALL (18/87 vs. 16/213, P = 0.001). At treatment day 15, five of 52 patients (10%) who had CSF positive by FCM at diagnosis remained so despite at least two doses of weekly intrathecal chemotherapy. Conclusions: Longer follow-up is needed to clarify whether FCM positivity has prognostic significance and is an indicator for intensified CNS-directed therapy.
(Less)
- author
- organization
- publishing date
- 2016-11-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute, ALL, CSF leukemia, leukemias, minimal residual disease
- in
- Pediatric Blood & Cancer
- volume
- 63
- issue
- 11
- pages
- 8 pages
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:84988370301
- pmid:27447373
- wos:000387023500012
- ISSN
- 1545-5009
- DOI
- 10.1002/pbc.26128
- language
- English
- LU publication?
- yes
- id
- de3e0bc9-0026-48ae-aae6-08424b7734a7
- date added to LUP
- 2017-01-17 08:10:43
- date last changed
- 2025-02-08 22:28:18
@article{de3e0bc9-0026-48ae-aae6-08424b7734a7, abstract = {{<p>Background: Central nervous system (CNS) involvement is associated with relapse in childhood acute lymphoblastic leukemia (ALL) and is a diagnostic challenge. Procedure: In a Nordic/Baltic prospective study, we assessed centralized flow cytometry (FCM) of locally fixed cerebrospinal fluid (CSF) samples versus local conventional cytospin-based cytology (CC) for detecting leukemic cells and evaluating kinetics of elimination of leukemic cells in CSF. Results: Among 300 patients with newly diagnosed ALL, 87 (29%) had CSF involvement by FCM, while CC was positive in 30 (10%) of 299 patients with available CC data (P < 0.001). Patients with FCM+/CC+ had higher CSF leukemic blast counts compared to patients positive by FCM only (medians: 0.10 vs. 0.017 leukemic blasts/μl, P = 0.006). Patients positive by FCM had higher white blood cell counts in peripheral blood than patients negative by FCM (medians: 45 × 10<sup>9</sup>/l vs. 10 × 10<sup>9</sup>/l, P < 0.001), were younger (medians: 3 years vs. 4 years, P = 0.03), and more frequently had T-cell ALL (18/87 vs. 16/213, P = 0.001). At treatment day 15, five of 52 patients (10%) who had CSF positive by FCM at diagnosis remained so despite at least two doses of weekly intrathecal chemotherapy. Conclusions: Longer follow-up is needed to clarify whether FCM positivity has prognostic significance and is an indicator for intensified CNS-directed therapy.</p>}}, author = {{Levinsen, Mette and Marquart, Hanne V. and Groth-Pedersen, Line and Abrahamsson, Jonas and Albertsen, Birgitte K. and Andersen, Mette K. and Frandsen, Thomas L. and Harila-Saari, Arja and Pronk, Cornelis and Ulvmoen, Aina and Vaitkevičienė, Goda and Lähteenmäki, Päivi M. and Niinimäki, Riitta and Taskinen, Mervi and Jeppesen, Maria and Schmiegelow, Kjeld}}, issn = {{1545-5009}}, keywords = {{acute; ALL; CSF leukemia; leukemias; minimal residual disease}}, language = {{eng}}, month = {{11}}, number = {{11}}, pages = {{1935--1942}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Pediatric Blood & Cancer}}, title = {{Leukemic blasts are present at low levels in spinal fluid in one-third of childhood acute lymphoblastic leukemia cases}}, url = {{http://dx.doi.org/10.1002/pbc.26128}}, doi = {{10.1002/pbc.26128}}, volume = {{63}}, year = {{2016}}, }