Minimal residual disease assessment in childhood acute lymphoblastic leukaemia: a Swedish multi-centre study comparing real-time polymerase chain reaction and multicolour flow cytometry.

Research output: Contribution to journalArticle


Minimal residual disease (MRD) assessment is a powerful prognostic factor for determining the risk of relapse in childhood acute lymphoblastic leukaemia (ALL). In this Swedish multi-centre study of childhood ALL diagnosed between 2002 and 2006, the MRD levels were analysed in 726 follow-up samples in 228 children using real-time quantitative polymerase chain reaction (RQ-PCR) of rearranged immunoglobulin/T-cell receptor genes and multicolour flow cytometry (FCM). Using an MRD threshold of 0·1%, which was the sensitivity level reached in all analyses, the concordance between RQ-PCR and FCM MRD values at day 29 was 84%. In B-cell precursor ALL, an MRD level of ≥0·1% at day 29 predicted a higher risk of bone marrow relapse (BMR) with both methods, although FCM was a better discriminator. However, considering the higher median MRD values achieved with RQ-PCR, a higher MRD cut-off (≥0·2%) improved the predictive capacity of RQ-PCR. In T-ALL, RQ-PCR was notably superior to FCM in predicting risk of BMR. That notwithstanding, MRD levels of ≥0·1%, detected by either method at day 29, could not predict isolated extramedullary relapse. In conclusion, the concordance between RQ-PCR and FCM was high and hence both methods are valuable clinical tools for identifying childhood ALL cases with increased risk of BMR.


  • Ingrid Thörnerup
  • Erik Forestier
  • Johan Botling
  • Britt Thuresson
  • Carina Wasslavik
  • Elisabet Björklund
  • Aihong Li
  • Eleonor Lindström-Eriksson
  • Maria Malec
  • Elisabeth Grönlund
  • Kerstin Torikka
  • Jesper Heldrup
  • Jonas Abrahamsson
  • Mikael Behrendtz
  • Stefan Söderhäll
  • Stefan Jacobsson
  • Tor Olofsson
  • Anna Porwit
  • Gudmar Lönnerholm
  • Richard Rosenquist
  • And 1 others
  • Christer Sundström
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology


  • childhood acute lymphoblastic leukaemia, disease, minimal residual, TCR genes, rearranged IG, flow cytometry, RQ-PCR
Original languageEnglish
Pages (from-to)743-753
JournalBritish Journal of Haematology
Issue number6
Publication statusPublished - 2011
Publication categoryResearch

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Family Medicine (013241010), Division of Hematology and Transfusion Medicine (013041100), Paediatrics (Lund) (013002000), Psychiatry/Primary Care/Public Health (013240500)