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Leukemic blasts are present at low levels in spinal fluid in one-third of childhood acute lymphoblastic leukemia cases

Levinsen, Mette ; Marquart, Hanne V. ; Groth-Pedersen, Line ; Abrahamsson, Jonas ; Albertsen, Birgitte K. ; Andersen, Mette K. ; Frandsen, Thomas L. ; Harila-Saari, Arja ; Pronk, Cornelis LU and Ulvmoen, Aina , et al. (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.

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organization
publishing date
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
  • pmid:27447373
  • wos:000387023500012
  • scopus:84988370301
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
2022-07-25 20:44:21
@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 &lt; 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 &lt; 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}},
}