Difference Of Monitoring Minimal Residual Disease Of Childhood With B-lineage Acute Lymphoblastic Leukemia Between Peripheral Blood And Bone Marrow

Objective Exploration of difference of monitoring minimal residual disease(MRD) at day 19 in childhood with B-lineage acute lymphoblastic leukemia(B-ALL) between peripheral blood bone marrow, and evaluation of it’s clinical significance.Methods Forty-four cases diagnosed B-ALL were enrolled in this study from February 2015 to January 2016 in Children’s Hospital of Soochow University. All patients treated with the acute lymphocytic leukemia multicenter group(CCCG- ALL)-2015 protocol. Four-color flow cytometry was used in monitoring MRD of peripheral blood(PB) and bone marrow(BM) at day 19 during remission induction.Results The Forty-four pairs Minimal Residual Disease in Peripheral Blood and Bone Marrow have a good correlation, the correlation coefficient is 0.713; But there are some differences in MRD positive rate, the MRD level, the number of each MRD level, the median time of remission induction in each MRD level.(1)Positive rate, the MRD results of 44 patients at day 19,bone marrow MRD positive rate 68%, peripheral blood MRD positive rate was 36.3%( P=0.003),the MRD positive rate of peripheral blood were significantly lower than the bone marrow.(2)The MRD level, the MRD level of peripheral blood below the bone marrow, the MRD results in bone marrow is peripheral blood average 13.4 times(0.89- 192 times).(3)The number of each MRD level, MRD<10-4(negative)、10-4-10-3 、10-3-10-2、≥10-2,in each MRD level,the number of bone marrow group respectively is 14,11,11,8,and the number of peripheral blood group respectively is 28,5,7,4(P=0.028).(4)The median time of remission induction in each MRD level, bone marrow or peripheral blood, the higher the MRD level, median time of remission induction the longer.(5)Analysis 15 patients who MRD positive both in bone marrow and peripheral blood and 15 patients who only MRD positive in bone marrow, although compare the former with the latter show high number of white blood cells(WBC>50×109 /L),high number of hormone is not sensitive, high number of HR and IR group, high number of the spleen enlargement, but Chi-square test shows: white blood cells(P=0.287),hormone is not sensitive(P=0.69),risk group(P=0.391),spleen enlargement(P=0.143),differences had no statistical significance.Conclusion(1) Monitoring MRD between PB and BM had a good correlation, and the correlation coefficient was 0.713;(2) BM cannot be replaced by PB on detection of MRD;(3) Compared with patients with MRD positive in BM, there was no statistical difference in cases with MRD positive both in BM and PB on clinical features.