doiSerbia

Immunoglobulin genes and T-cell receptors as molecular markers in children with acute lymphoblastic leukaemia

Lazić Jelena (Služba za hematologiju i onkologiju, Univerzitetska dečja klinika, Beograd)
Dokmanović Lidija (Služba za hematologiju i onkologiju, Univerzitetska dečja klinika, Beograd)
Krstovski Nada (Služba za hematologiju i onkologiju, Univerzitetska dečja klinika, Beograd)
Predojević Jelica (Dečja klinika, Kliničko-bolnički centar, Banja Luka, Bosna i Hercegovina)
Tošić Nataša (Institut za molekularnu genetiku i genetičko inženjerstvo, Beograd)
Pavlović Sonja (Institut za molekularnu genetiku i genetičko inženjerstvo, Beograd)
Janić Dragana (Služba za hematologiju i onkologiju, Univerzitetska dečja klinika, Beograd)

Introduction. Acute lymphoblastic leukaemia (ALL) is a malignant clonal disease, one of the most common malignancies in childhood. Contemporary protocols ensure high remission rate and long term free survival. The ability of molecular genetic methods help to establish submicroscopic classification and minimal residual disease (MRD) follow up, in major percent responsible for relapse. Objective. The aim of the study was to detect the frequency of IgH and TCR gene rearrangements and their correlation with clinical parameters. Methods. Forty-one children with ALL were enrolled in the study group, with initial diagnosis of IgH and TCR gene rearrangements by polimerase chain reaction ( PCR). MRD follow-up was performed in induction phase when morphological remission was expected, and after intensive chemiotherapy. Results. In the study group IgH rearrangement was detected in 82.9% of children at the diagnosis, while TCR rearrangement was seen in 56.1%. On induction day 33, clonal IgH rearrangements persisted in 39% and TCR rearrangements in 36.5% of children. Conclusion. Molecular analysis of genetic alterations and their correlation with standard prognostic parameters show the importance of risk stratification revision which leads to new therapy intensification approach. MRD stands out as a precise predictive factor for the relapse of disease.

Keywords: acute lymphoblast leukaemia, minimal residual disease, IgH and TCR gene rearrangements