The clinical significance of current laboratory and other prognostic indicators in the management of South African children with Precursor B cell acute lymphoblastic leukaemia
Date
2009-09-17T08:53:06Z
Authors
Schapkaitz, Elise
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Abstract
This study aimed to identify the relevance of these prognostic features in the modern
treatment era in South African children. A retrospective analysis of the presentation
clinical and laboratory features and treatment outcomes of all children treated for
Precursor B cell ALL at the Johannesburg Hospital was performed.
Between January 1997 and May 2007, 100 children were reviewed. Clinical features
(age, race and gender) emerged as significant prognostic variables. Laboratory features
(white cell count and genetic features) lacked significance. Early morphologic response
on day 15 identified a subgroup associated with a favourable outcome. However the
presence of > 5% blasts was not significantly predictive of relapse or death at this time
point. Minimal residual disease (MRD) detection by modified immunoglobulin gene
rearrangement and flow cytometry techniques did not improve the predictive value of the
morphological assessment.
In a low resource setting, the challenge is to design cost effective MRD detection
methods to improve the identification of patients at risk for relapse.
Description
M.Med.(Haematology), Faculty of Health Sciences, University of the Witwatersrand, 2008
Keywords
Precursor B cell, acute lymphoblastic leukaemia