Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

Background: Minimal residual disease (MRD) in childhood acute lymphoblastic leukemia (ALL) during the early stages of therapy is statistically significant indicator of outcome. Aim: To study the prognostic significance of MRD by flow-cytometry in peripheral blood (PB) on day-8 induction in pediatric B-precursor ALL. Patients and Methods: This is study included 140 newly diagnosed B-precursor ALL pediatric patients treated at the Children{u2019}s Cancer Hospital- Egypt during the period between mid of March 2010 and end of September 2011. ALL patients received adopted protocol of St. Jude Children{u2019}s Research Hospital total study XV for low or standard/high risk ALL. Results: The 3-year relapse-free survival (RFS) and event-free survival (EFS) were 87±3.5% and 82±3.7% respectively. Median follow up was 34.9 months (range 24{u2013}42). MRD PB day-8 <1% was encountered in 78% of patients. Patients with day-8 MRD <1% had 3-year RFS of 90.6±3.4% compared to 73±10.7% for day-8 MRD {u2265}1% (P=0.042). Prognostic factors had statistically significant impact on RFS by univariate analysis were patient risk, favorable triple trisomies, and MRD PB day-8. By multivariate analysis, patient risk was the only independent factor affecting RFS

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