Cytogenetic Cr

There are no prospective studies to evaluate the role of complete cytogenetic remission in ALL. Cytogenetic analysis, based on at least 20 metaphases, can detect one residual metaphase, resulting in a sensitivity of 5%. As was described earlier, flow cytometry and molecular testing (see below) can detect one abnormal cell in 103-104 normal cells. Minimal residual disease, detected by either of these two methods, was proven to be an independent prognostic factor in ALL (see above for flow cytometry and below for molecular target). Therefore, complete cytogenetic remission should be evaluated prospectively in ALL clinical trials to determine its significance for the prediction of outcome.

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