Julie Joseph, Sheela Thomas, Ajith Kumar
BACKGROUND In India, leukaemia continues to be the largest contributor to cancer-related mortality in children. The potential applications of minimal residual disease studies in the clinical management of acute leukaemia include early identification of patients at a higher risk of relapse. The aim of the study were to determine- 1. The extent of clearance of leukaemic cells as assessed by Peripheral blood, Bone marrow aspirate on day 28 and Flow cytometry in paediatric B- ALL patients. 2. Its association with standard prognostic variables. MATERIALS AND METHODS Immunophenotyping with flow cytometry (4 colour) was used along with peripheral smear, bone marrow, clinical and laboratory details in a prospective cohort study among paediatric B-cell ALL patients in a tertiary level referral centre from December 2014 - June 2016. Statistical analysis was done using SPSS 18. RESULTS Analysis of 35 paediatric B- ALL cases showed that those with central nervous system involvement at the time of diagnosis had more chance of minimal residual disease positivity after induction chemotherapy (p=0.001). The patients who showed blasts in their day 7 peripheral blood also had MRD (p=0.001). This study also showed that CD34 down modulation showed a positive correlation with presence of MRD (p=0.048). CONCLUSION The patients assigned to standard risk category by conventional prognostic factors will benefit by the detection of MRD by flow cytometry at the end of induction chemotherapy. MRD detection using flow cytometer (4 color) will provide a basis for future clinical decision making in the management of ALL cases.
