St. Jude develops more affordable ALL follow-up test

Investigators at St. Jude Children's Research Hospital have developed a relatively simple and inexpensive test that identifies children with acute lymphoblastic leukemia (ALL) who have responded well enough to their first round of chemotherapy that they might be successfully treated with a much less aggressive follow-up treatment.

The new test could give hospitals with limited resources an affordable way to improve the outcome of ALL treatment for many children by reducing chemotherapy side effects.

A report on this new technique appears in the March pre-publication online issue of Blood.

The test measures minimal residual disease (MRD)--the small number of leukemic cells that survive after remission induction therapy. This measurement helps clinicians identify patients whose disease is highly responsive to chemotherapy and those who might be cured with milder and less toxic treatment.

The study found that the new test provides results that are acceptably close to those obtained with more complex and expensive MRD tests, which can be performed only at a few cancer centers worldwide. The new assay uses only one test tube with three probes that can distinguish leukemic cells from normal cells in the bone marrow of children with ALL taken after two weeks of chemotherapy, according to the paper's senior author, Dario Campana, M.D., Ph.D., a member of the St. Jude Hematology-Oncology and Pathology Departments.

The high cost and complexity of the more sophisticated MRD tests have impeded their use in countries with limited resources, Campana said. "That limited the number of children who could benefit from MRD assays," he said. "The test we developed will allow clinicians at institutions with limited resources to reliably identify children who could be spared the harsh side effects caused by intense chemotherapy."

The investigators used the new test to examine bone marrow cells collected from 380 children with B-lineage

Contact: Kelly Perry
St. Jude Children's Research Hospital

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