14 February 2022

A new monitoring tool has been developed to detect relapse in children with acute lymphoblastic leukaemia.

Dr Cornelia Eckert and colleagues at the Charité-Universitätsmedizin in Berlin, the German Cancer Consortium (DKTK), and the German Cancer Research Center (DKFZ) outlined the tool recently in Journal of Molecular Diagnostics.

They explain: “Acute lymphoblastic leukaemia is the most frequent malignancy in childhood. Minimal residual disease monitoring is an important prognostic factor for treatment response and patient stratification.”

This is not straightforward, they add, because markers of minimal residual disease (MRD) can disappear or change during treatment. So multiple markers need to be monitored.

The research team developed a multiplex test that is able to detect a number of DNA changes in biological samples, such as gene fusions and gene deletions. These personalised assays can “precisely quantify more minimal residual disease markers in less sample material”, they report.

A new protocol for using this improved monitoring of cancer recurrence has also been created. Dr Eckert and her team point out that this method is simpler than the current approach and detects relapse sooner.

She says: “Minimal residual disease markers can disappear during treatment, which can lead to false-negative results and poor decision-making in personalised treatments."

Co-author Dr Michael Lehnert adds: “Multiplexing can significantly improve personalised minimal residual disease monitoring of patients, because a higher number of minimal residual disease markers per patient can be analysed at the same time.

“Even though these patient-specific sequences of cancer cells only differ in a few DNA nucleotides from healthy cells, our multiplex assay can still distinguish between these DNA sequences. Therefore, a broader range of patient-specific sequences can be included in the assay.”

Source: Kipf E, Schlenker F, Borst N, Fillies M, Kirschner-Schwabe R, Zengerle R, Eckert C, von Stetten F, Lehnert M (2021) “Advanced Minimal Residual Disease Monitoring for Acute Lymphoblastic Leukemia with Multiplex Mediator Probe PCR.” Journal of Molecular Diagnostics, doi: 10.1016/j.jmoldx.2021.10.001

Link: https://www.jmdjournal.org/article/S1525-1578(21)00331-7/fulltext

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