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Year : 2016  |  Volume : 7  |  Issue : 1  |  Page : 17-23

Minimal residual disease program for acute lymphoblastic leukemia at Dhahran Health Center

1 Pathology Services Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
2 Hematology/Oncology Services Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
3 Clinical Laboratory Services Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia

Correspondence Address:
Nasir Khalid Amra
Dhahran Health Center, John Hopkins Aramco Healthcare, Building 62, Room No. 294, Dhahran 31311
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1658-5127.181113

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Background and Objectives: Minimal residual disease (MRD) assays for monitoring acute lymphoblastic leukemia (ALL) during treatment are defined as assays with a limit of detection of at least 0.01% leukemic blasts per mononuclear cells or total nucleated cells. Settings and Design: We retrospectively reviewed out experience at Dhahran Health Center in monitoring adult and pediatric ALL patients with a MRD assay based on immunophenotyping by flow cytometry with a level of detection of 0.01% leukemic blasts per mononuclear cells and compute Kaplan–Meier survival analysis for overall survival (OS) and relapse-free survival (RFS). We also demonstrated the incorporation of an estimated measurement uncertainty for the reported MRD values based on metrological principles. Methods: A retrospective review of all cases diagnosed with ALL from 2006 to 2012 was undertaken and after applying exclusion criteria, 26 cases were identified and patient chart review was done. Results: Although the Kaplan–Meier survival analysis for OS and RFS do demonstrate a statistically significant difference between MRD positive and negative patients, none of the pediatric ALL MRD positive cases have relapsed till now. Conclusions: The detection of MRD in ALL opens up the opportunity to intensify or alter treatment for patients with detectable levels by a highly sensitive assay before clinical relapse.

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