Published in Cancer Detection and Prevention 1993; 17(1).

Is bone marrow morphology sufficient to gauge complete remission in acute leukemia ? major role of cytogenetic analysis

Raynaud, S.D.1, Brunet, B.1, Gratecos, N.2, Deville, A.3, Monpoux, F.4, Bayle, J.5, Lagrange, M.6, Ayraud, N.1.

1Laboratoire de Genetique, CNRS URA 1462, Av. de Valombrose, 06107 Nice cedex 2. 2Service de Medecine Interne 1, CHU Nice. 3Service d'Oncologie Pediatrique, Hopital Lenval, Nice. 4Service de Pediatrie, CHU Nice. 5Laboratoire Central d'Hematologie, CHU, Nice. 6Laboratoire d'Hematooncologie, Fondation Pasquetta, Nice, France.

Assessment of a complete remission (CR) in patients with acute leukemia (ALL or ANLL) treated by intensive timed sequential chemotherapy is usually based on bone marrow morphology, which defines CR as < 3-5 % blasts. Cytogenetic analysis is rarely used as a response criterion for therapy. We report here the cytogenetic monitoring of 8 patients who originally presented with acute leukemia. All 8 fulfilled the morphologic criteria of CR but proved to have an abnormal cytogenetic clone (5-30 % of analysed metaphases) indicating the existence of residual disease which could not be detected by standard morphologic analysis. Therefore we suggest that cytogenetic investigation should be part of the response criteria for therapy in patients with acute leukemia.

Paper presented at the International Symposium on Genetic Factors in Predictive and Preventive Oncology; Nice, France; March 14-16, 1993; in the section on Prognostic Indicators.