Prognostic significance of bi/oligoclonality in childhood acute lymphoblastic leukemia as determined by polymerase chain reaction
Palavras-chave:
Leucemia linfóide aguda da infância, Reação em cadeia da polimerase, OligoclonalidadeResumo
INTRODUÇÃO: A região CDR-3 da IgH têm sido usada com marcador clonal no estudo de doença residual mínima em crianças com leu- cemia linfóide aguda. Estudos por Southern blot e reação em cadeia da polimerase têm demonstrado bi/oligoclonalidade em um número variável de casos de leucemia linfóide aguda de linhagem B, o que pode interferir de forma importante na detecção de doença residual mínima. Oligoclonalidade também têm sido associada com pior prognóstico e maior chance de recidiva. OBJETIVOS: Correlacionar bi/oligoclonalidade detectada por reação em cadeia da polimerase em crianças brasileiras portadoras de leucemia linfóide aguda de linhagem B com chance de recaída, imunofenótipo, grupo de risco e sobrevida livre de doença. TIPO DE ESTUDO: Estudo prospectivo de seguimento de pacientes. LOCAL: Serviço de Oncologia Pediátrica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto- USP. PARTICIPANTES: 47 crianças portadoras de leucemia linfóide aguda de linhagem B TESTE DIAGNÓSTICO: Reação em cadeia da polimerase, utilizando-se primers de consenso para região CDR-3 da IgH (FR3A, LJH e VLJH) para detecção de clonalidade. RESULTADOS: Bi/oligoclonalidade foi encontrada em 15 pacientes (31,9%). Não houve diferença estatística significativa entre os grupos com monoclonalidade e biclonalidade quanto a presença de recidiva (28,1% versus 26,1%) , presença de CALLA+ (81,2% versus 80%) ou grupo de risco (62,5% versus 60%). Sobrevida livre de doença foi similar em ambos os grupos, sem diferença significativa (p: 0,7695). CONCLUSÕES: Concluímos que bi/oligo-clonalidade não esteve associada com fatores os analisados neste estudo e que sua detecção em 31,9% dos pacientes pode ser importante no estudo e seguimento de doença residual mínima.
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