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Next-generation sequencing indicates false-positive MRD results and better predicts prognosis after SCT in patients with childhood ALL.

Abstract：

:Minimal residual disease (MRD) monitoring via quantitative PCR (qPCR) detection of Ag receptor gene rearrangements has been the most sensitive method for predicting prognosis and making post-transplant treatment decisions for patients with ALL. Despite the broad clinical usefulness and standardization of this method, we and others have repeatedly reported the possibility of false-positive MRD results caused by massive B-lymphocyte regeneration after stem cell transplantation (SCT). Next-generation sequencing (NGS) enables precise and sensitive detection of multiple Ag receptor rearrangements, thus providing a more specific readout compared to qPCR. We investigated two cohorts of children with ALL who underwent SCT (30 patients and 228 samples). The first cohort consisted of 17 patients who remained in long-term CR after SCT despite having low MRD positivity (<0.01%) at least once during post-SCT monitoring using qPCR. Only one of 27 qPCR-positive samples was confirmed to be positive by NGS. Conversely, 10 of 15 samples with low qPCR-detected MRD positivity from 13 patients who subsequently relapsed were also confirmed to be positive by NGS (P=0.002). These data show that NGS has a better specificity in post-SCT ALL management and indicate that treatment interventions aimed at reverting impending relapse should not be based on qPCR only.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Kotrova M,van der Velden VHJ,van Dongen JJM,Formankova R,Sedlacek P,Brüggemann M,Zuna J,Stary J,Trka J,Fronkova E

doi

10.1038/bmt.2017.16

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

962-968

issue

7

eissn

0268-3369

issn

1476-5365

pii

bmt201716

journal_volume

52

pub_type

临床试验,杂志文章,多中心研究

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