Immunophenotypic Cr

Patients who achieve morphologic CR can be further categorized based on additional and more sensitive methods. Flow cytometry identifies leukemia-associated marker patterns on the surface of, or inside, the blasts. These patterns include over-expression (e.g., for B lineage: CD10, CD19, CD20) as well as under-expression (e.g., CD45) of markers compared with their expression on normal lymphoid cells. Overall, persistence of a unique phenotype determined by flow cytometry, e.g., CD10 and CD20 coexpression, has been associated with worse outcome and should be viewed as

Table 14.1 Sensitivity of minimal residual disease detection by flow cytometry

Disease Sensitivity References

Adult and childhood ALL TdT <100 X 103, 10

Adult and childhood ALL TdT <100 X 103, 10

Childhood ALL

1:1 X 104

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