Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children

Acute megakaryoblastic leukemia (AMKL) is a rare subtype of acute myeloid leukemia (AML), which is associated with poor prognosis for all patients except children with t(1;22) or Down syndrome. The frequency of complete remission in case of AMKL is comparable to the frequency of complete remission i...

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Autores principales:	Alexandra D. Palladina, Aleksandr V. Popa, Timur T. Valiev, Valentin G. Nikitaev, Olga A. Chernysheva, Natalia A. Kupryshina, Irina N. Serebryakova, Tamara V. Shvedova, Konstantin L. Kondratchik, Nikolai N. Tupitsyn
Formato:	article
Lenguaje:	RU
Publicado:	IP Habib O.N. 2021
Materias:	acute megakaryoblastic leukemia m7 minimal residual disease Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/da34523d644c47bfa0efb92a4a548e46
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spelling	oai:doaj.org-article:da34523d644c47bfa0efb92a4a548e462021-11-30T16:55:01ZDetection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children1815-14341815-144210.26442/18151434.2021.1.200762https://doaj.org/article/da34523d644c47bfa0efb92a4a548e462021-05-01T00:00:00Zhttps://modernonco.orscience.ru/1815-1434/article/viewFile/70472/51396https://doaj.org/toc/1815-1434https://doaj.org/toc/1815-1442Acute megakaryoblastic leukemia (AMKL) is a rare subtype of acute myeloid leukemia (AML), which is associated with poor prognosis for all patients except children with t(1;22) or Down syndrome. The frequency of complete remission in case of AMKL is comparable to the frequency of complete remission in other variants of AML, and the median survival is much lower. This determines the necessity to update criteria for assessment of the effect of treatment using flow cytometry definition of the level of minimal residual disease (MRD). Nowadays, there are no unified and standardized approaches for the measurement of MRD in case of myeloid leukemia, including AMKL, which prohibits adequate assessment of the therapy effect and in some cases determination of the indications for allogeneic hematopoietic stem cells transplantation. The article identifies diagnostic features and describes approaches for the measurement of the level of MRD in case of AMKL. Aim. The aim is to demonstrate the algorithms for diagnosing and measuring MRD in case of AML-M7 in children. Materials and methods. The article analyzes the clinical and immunological profile of 10 boys and 4 girls with the initial diagnosis of AMKL between the ages of 3 months 12 years old, 13 of them have received treatment in the FSBI N.N. Blokhin National Medical Research Center of Oncology and one in the GBUZ Morozovsky DGKB between 1995 and 2020, The measurement of MRD was carried out in 6 patients. The measurement of MRD was carried out using both morphocytochemical method and multiparameter flow cytometry with megakaryocyte markers (CD61, CD42, CD41) in combination with other myeloid markers (CD13, CD33), CD34, CD117 and aberrant markers (mainly CD7). Results. We showed that adequate measurement of the level of MRD had required detailed immunophenotyping during diagnosis to determine the aberration of megakaryoblasts. CD9 marker (100%), CD33 myeloid marker (69.2%), stem cell antigen CD34 (46.2%), CD13 (38.2%) in addition to megakaryocyte markers (100%) were most often expressed on blast cells in case of AMKL. The CD117 antigen was present on the blasts in 33.3% of cases. The expression of the T-cell-associated CD7 antigen (46.2%) was frequent. The measurement of MRD was carried out during the treatment (usually after an induction course) on the basis of the markers of megakaryocytic cell line (CD61, CD41, CD42a, CD42b), weak CD45 expression, as well as the immunophenotype characteristics during initial diagnosis. The level of MRD ranged from completely negative (0%; 0.006%) to evident (1.05%). Conclusion. The detection of residual tumor megakaryoblasts in case of AML-M7 using flow cytometry is a promising method to evaluate the effect of therapy. The adequate measurement of the level of MRD requires detailed immunophenotyping during the diagnosis to determine the aberration of megakaryoblasts.Alexandra D. PalladinaAleksandr V. PopaTimur T. ValievValentin G. NikitaevOlga A. ChernyshevaNatalia A. KupryshinaIrina N. SerebryakovaTamara V. ShvedovaKonstantin L. KondratchikNikolai N. TupitsynIP Habib O.N.articleacute megakaryoblastic leukemiam7minimal residual diseaseNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282RUСовременная онкология, Vol 23, Iss 1, Pp 148-155 (2021)
institution	DOAJ
collection	DOAJ
language	RU
topic	acute megakaryoblastic leukemia m7 minimal residual disease Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	acute megakaryoblastic leukemia m7 minimal residual disease Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Alexandra D. Palladina Aleksandr V. Popa Timur T. Valiev Valentin G. Nikitaev Olga A. Chernysheva Natalia A. Kupryshina Irina N. Serebryakova Tamara V. Shvedova Konstantin L. Kondratchik Nikolai N. Tupitsyn Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children
description	Acute megakaryoblastic leukemia (AMKL) is a rare subtype of acute myeloid leukemia (AML), which is associated with poor prognosis for all patients except children with t(1;22) or Down syndrome. The frequency of complete remission in case of AMKL is comparable to the frequency of complete remission in other variants of AML, and the median survival is much lower. This determines the necessity to update criteria for assessment of the effect of treatment using flow cytometry definition of the level of minimal residual disease (MRD). Nowadays, there are no unified and standardized approaches for the measurement of MRD in case of myeloid leukemia, including AMKL, which prohibits adequate assessment of the therapy effect and in some cases determination of the indications for allogeneic hematopoietic stem cells transplantation. The article identifies diagnostic features and describes approaches for the measurement of the level of MRD in case of AMKL. Aim. The aim is to demonstrate the algorithms for diagnosing and measuring MRD in case of AML-M7 in children. Materials and methods. The article analyzes the clinical and immunological profile of 10 boys and 4 girls with the initial diagnosis of AMKL between the ages of 3 months 12 years old, 13 of them have received treatment in the FSBI N.N. Blokhin National Medical Research Center of Oncology and one in the GBUZ Morozovsky DGKB between 1995 and 2020, The measurement of MRD was carried out in 6 patients. The measurement of MRD was carried out using both morphocytochemical method and multiparameter flow cytometry with megakaryocyte markers (CD61, CD42, CD41) in combination with other myeloid markers (CD13, CD33), CD34, CD117 and aberrant markers (mainly CD7). Results. We showed that adequate measurement of the level of MRD had required detailed immunophenotyping during diagnosis to determine the aberration of megakaryoblasts. CD9 marker (100%), CD33 myeloid marker (69.2%), stem cell antigen CD34 (46.2%), CD13 (38.2%) in addition to megakaryocyte markers (100%) were most often expressed on blast cells in case of AMKL. The CD117 antigen was present on the blasts in 33.3% of cases. The expression of the T-cell-associated CD7 antigen (46.2%) was frequent. The measurement of MRD was carried out during the treatment (usually after an induction course) on the basis of the markers of megakaryocytic cell line (CD61, CD41, CD42a, CD42b), weak CD45 expression, as well as the immunophenotype characteristics during initial diagnosis. The level of MRD ranged from completely negative (0%; 0.006%) to evident (1.05%). Conclusion. The detection of residual tumor megakaryoblasts in case of AML-M7 using flow cytometry is a promising method to evaluate the effect of therapy. The adequate measurement of the level of MRD requires detailed immunophenotyping during the diagnosis to determine the aberration of megakaryoblasts.
format	article
author	Alexandra D. Palladina Aleksandr V. Popa Timur T. Valiev Valentin G. Nikitaev Olga A. Chernysheva Natalia A. Kupryshina Irina N. Serebryakova Tamara V. Shvedova Konstantin L. Kondratchik Nikolai N. Tupitsyn
author_facet	Alexandra D. Palladina Aleksandr V. Popa Timur T. Valiev Valentin G. Nikitaev Olga A. Chernysheva Natalia A. Kupryshina Irina N. Serebryakova Tamara V. Shvedova Konstantin L. Kondratchik Nikolai N. Tupitsyn
author_sort	Alexandra D. Palladina
title	Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children
title_short	Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children
title_full	Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children
title_fullStr	Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children
title_full_unstemmed	Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children
title_sort	detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children
publisher	IP Habib O.N.
publishDate	2021
url	https://doaj.org/article/da34523d644c47bfa0efb92a4a548e46
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Detection and monitoring of minimal residual disease in acute megakaryoblastic leukemia in children

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