Value of flow cytometry for MRD-based relapse prediction in B-cell precursor ALL in a multicenter setting

PCR of TCR/Ig gene rearrangements is considered the method of choice for minimal residual disease (MRD) quantification in BCP-ALL, but flow cytometry analysis of leukemia-associated immunophenotypes (FCM-MRD) is faster and biologically more informative. FCM-MRD performed in 18 laboratories across seven countries was used for risk stratification of 1487 patients with BCP-ALL enrolled in the NOPHO ALL2008 protocol. When no informative FCM-marker was available, risk stratification was based on real-time quantitative PCR. An informative FCM-marker was found in 96.2% and only two patients (0.14%) had non-informative FCM and non-informative PCR-markers. The overall 5-year event-free survival was 86.1% with a cumulative incidence of relapse (CIR5y) of 9.5%. FCM-MRD levels on days 15 (HzR 4.0, p 10(-4) associated with a CIR5y = 22.1%. In conclusion, FCM-MRD performed in a multicenter setting is a clinically useful method for MRD-based treatment stratification in BCP-ALL.Peer reviewe

Changes in reticulorumen content temperature and pH according to time of day and yearly seasons

The monitoring of rumen content temperature can be useful for the evaluation of cow health condition and heat. The aim of this research was to evaluate the influence of the circadian rhythm (time of day) and season on reticulorumen acidity (pH) and temperatures (RT) in lactating dairy cows. The research was performed on ten 2nd – lactation, clinically healthy Lithuanian Black and White fresh dairy cows (up to 1 day after calving). The cows were milked twice daily at 05:00 and 17:00. The cows were kept in a loose housing system, and were fed a feed ration throughout the year at the same time, balanced according to their physiological needs. Cow feeding took place every day at 06:00 and 18:00. The pH and temperature of the contents of cow reticulorumens were measured using specific smaXtec boluses manufactured for animal care. The temperature starts rising 6 hours after the evening feeding and milking, whereas 1 hour after the morning milking, it starts decreasing. The lowest temperature observed in the springtime was 38.81±0.001, and the highest was in autumn 39.17±0.001. The pH starts decreasing 3 hours after the morning feed, whereas 4 hours after the evening feed, it starts increasing. The lowest pH was observed in the summertime – 5.99±0.001, and the highest was in autumn and springtime – 6.18±0.001. In conclusion the reticulorumen temperature in lactating cows was found to be influenced by the circadian rhythm and season. The acidity of the reticulorumen content changes similar to the temperature. The pH of the reticulorumen contents was also found to be influenced by the circadian rhythm and season

Report on national ICP IM activities in Lithuania

Vytauto Didžiojo universitetasŽemės ūkio akademij

Report on ICP IM activities in Lithuania

Vytauto Didžiojo universitetasŽemės ūkio akademij

Minimal residual disease quantification by flow cytometry provides reliable risk stratification in T-cell acute lymphoblastic leukemia.

To access publisher's full text version of this article click on the hyperlink belowMinimal residual disease (MRD) measured by PCR of clonal IgH/TCR rearrangements predicts relapse in T-cell acute lymphoblastic leukemia (T-ALL) and serves as risk stratification tool. Since 10% of patients have no suitable PCR-marker, we evaluated flowcytometry (FCM)-based MRD for risk stratification. We included 274 T-ALL patients treated in the NOPHO-ALL2008 protocol. MRD was measured by six-color FCM and real-time quantitative PCR. Day 29 PCR-MRD (cut-off 10-3) was used for risk stratification. At diagnosis, 93% had an FCM-marker for MRD monitoring, 84% a PCR-marker, and 99.3% (272/274) had a marker when combining the two. Adjusted for age and WBC, the hazard ratio for relapse was 3.55 (95% CI 1.4-9.0, p = 0.008) for day 29 FCM-MRD ≥ 10-3 and 5.6 (95% CI 2.0-16, p = 0.001) for PCR-MRD ≥ 10-3 compared with MRD < 10-3. Patients stratified to intermediate-risk therapy on day 29 with MRD 10-4-<10-3 had a 5-year event-free survival similar to intermediate-risk patients with MRD < 10-4 or undetectable, regardless of method for monitoring. Patients with day 15 FCM-MRD < 10-4 had a cumulative incidence of relapse of 2.3% (95% CI 0-6.8, n = 59). Thus, FCM-MRD allows early identification of patients eligible for reduced intensity therapy, but this needs further studies. In conclusion, FCM-MRD provides reliable risk prediction for T-ALL and can be used for stratification when no PCR-marker is available