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Inexpensive ALL Follow-Up Test Developed By St. Jude Researchers

A simple and an affordable follow-up test to identify children with acute lymphoblastic anemia (ALL), who respond well to their first chemotherapy regimen, // has been developed by researchers at St. Jude Children's Research Hospital. Such children who have a good response may then be treated by a less aggressive treatment, during subsequent follow up visits.

This new test is based on testing of minimal residual disease (MRD), the relatively low percentage of leukemic cells, which survive following remission induction therapy treatment. This test would reduce the side effects associated with high chemotherapy doses and hence substantially improve the treatment outcome in children with ALL.

The test helps clinician's identify and distinguish highly responsive disease from the treatment resistant forms. Appropriate decisions can then be taken regarding institution of milder, less toxic treatment modalities. Researchers interested in this cost-effective technique can cite the article, published in the online issue of the Blood journal.

Normal bone marrow derived cells harvested from ALL children, after 2 weeks of chemotherapy treatment are placed in a test tube that contains three probes. These probes are highly specific and therefore help in differentiating cancer cells from normal cells.

The test was conducted on 380 children with a diagnosis of ALL (B-lymphocyte origin), 19 days after the initiation of remission induction therapy. The test determined the presence of leukemic cells, in more than half of the patients (211, 55.5%) even if the cancer cells made up 0.01% or more of the total sample.

The incidence of relapse in patients diagnosed with 0.01% or more of leukemic cells on day 19 was about 29% after a period of 10 years. In those who had less than 0.01% of leukemic cells, the relapse incidence was as low as 5%. The simple test was able to accurately identify which patients would respond well to chemo
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