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The clinical relevance of detection of minimal residual disease in childhood acute lymphoblastic leukaemia

Department of Paediatric Oncology and Haematology, Bristol Royal Hospital for Children, Bristol BS2 8JD, UK

Correspondence to:
Dr N J Goulden, Department of Paediatric Oncology and Haematology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8JD, UK;
nick.goulden{at}ubht.swest.nhs.uk
ABSTRACT
Risk directed treatment forms a central component of modern protocols for childhood acute lymphoblastic leukaemia (ALL). A review of recent studies of minimal residual disease (MRD) analysis shows that it is a powerful prognostic factor in both first line and relapse treatment. However, the value of MRD analysis is both time point and protocol specific, and the threshold for MRD detection of the technique used impacts upon the results obtained. MRD analysis does have a useful role to play in the risk directed treatment of childhood ALL, and this is currently being investigated in large prospective studies.

Keywords: children; lymphoblastic leukaemia; minimal residual disease

Abbreviations: ALL, acute lymphoblastic leukaemia; BFM, Berlin–Frankfurt–Munster; BMT, bone marrow transplantation; CR2, second complete remission; EORTC, European Organisation for Research and Treatment of Cancer; EFS, event free survival; FACS, fluorescence activated cell sorter; MRD, minimal residual disease; PCR, polymerase chain reaction; RFS, relapse free survival; WCC, white blood cell count

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