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SCIENTIFIC-PRACTICAL PEER-REVIEWED MONTHLY JOURNAL.
INSTITUTION OF MINISTRY OF PUBLIC HEALTH OF THE REPUBLIC OF BELARUS

PROGNOSTIC SIGNIFICANCE OF MINIMAL RESIDUAL DISEASE IN CHILDREN WITH ACUTE MYELOID LEUKAEMIA

Objective. Estimation of the prognostic role of the minimal residual disease (MRD) determined by multicolour flow-cytometry in the bone marrow of the pediatric patients with acute myeloid leukemia (AML) treated according to the AML-MM-2006 and AML-MM-2014 protocols at the end of the induction therapy.

Materials and methods. The study included 43 patients among them 29 (67.4%) boys and 14 (32.6%) girls. The median age was 8.07 years. The residual tumor cells were determined by 8-color flow cytofluorometry on a Navios device (Beckman Coulter, USA) using the reagents of this company.

Results. Determination of the leukemia-associated immunophenotype at the time of diagnosis and of MRD presence was successful in 91.5% of patients. 23.2% of patients had the MRD level in the bone marrow less than 0.1% at the end of the induction therapy (28—43 days of therapy). The remaining patients (76.8%) had the MRD level 0.1% or higher. Among the patients with MRD<0.1%, the M2 morphology of the blast cells and t(8; 21) occurred more often than in the group of patients with MRD³0.1%. Patients with MRD<0.1% were older 10 years in 80% of cases. 5-year event-free survival among the patients with MRD<0.1% was 100% at the end of the induction therapy being statistically significantly (p=0.0491) higher when compared with the same parameter in the group of patients with MRD³0.1% — 55%±11%.

Conclusion. Our results show that MRD detected by flow-cytometry after the induction therapy predicts negative outcomes in patients with childhood AML and can help stratifying the post-remission treatment.