부산대학교 도서관

In pediatric acute lymphoblastic leukemia(ALL), we know that early treatment response and favorable genetic alterations are important in disease free survival and overall life expectancy. In this study we tried to find some associations regarding genetic alterations and flowcytometric feature, minimal residual disease (MRD), in survival of children with ALL. Overall, 92 ALL patients were detected at medical records. Sixty six of them completed induction treatment at our center. Initial leukocyte count, lymphoblast count on day 8, remission evaluation of bone marrow on days 15 and 33, karyotype and cytogenetic analysis were retrospectively evaluated. 83.2% of patients were B-ALL. Of 66 patients whose remission induction was completed, 40 were included in intermediate risk group. Numerical chromosomal abnormalities were detected in 20 patients; whereas structural chromosomal abnormality in 34. In patients with numeric and structural abnormality, 2 patients were dead in each group. Besides in 30 patients with no structural abnormality, 7 of them were dead at time of analysis. The 5-year event-free survival of 66 patients was 71.4% (p< 0.001) and overall survival was 87.5% (p< 0.001). Event-free and overall survival were significantly higher in patients with lower 15th and 33rd day MRD analysis (p< 0.001). There may be some discordance between MRD and genetic abnormalities in few cases; but better results can be obtained with MRD lower than 10-4 during induction. There are still factors that have been undetermined in prediction of prognosis in ALL. Targeted personalized treatments with detailed genetic and cellular analysis would be the future in leukemia. [ABSTRACT FROM AUTHOR]