Table 2.
Minimal disease detection for children with anaplastic large cell lymphoma (ALCL).
| (A) Methods to measure minimal disease in ALK-positive anaplastic large cell lymphoma (ALCL). | ||||
| RT-PCR NPM–ALK Transcripts |
RQ-PCR NPM–ALK
Transcripts |
dPCR NPM–ALK
Transcripts |
RQ-PCR
for DNA Break |
|
|---|---|---|---|---|
| Applicability | 85% | 85% | 85% | n.k. |
| Sensitivity | ≤10−5 | ≤10−5 | ≤10−5 | ≤10−5 |
| Advantage | easy QC, inexpensive |
allows following response to therapies | High sensitivity QC easier compared to RQ-PCR |
Patient-specific ctDNA detectable |
| Disadvantage | no quantitative response monitoring | difficult to harmonize, expensive |
expensive | fresh tumor needed, expensive, laborious |
| (B) Established clinical applications for minimal disseminated (MDD) and minimal residual disease (MRD) in ALK-positive anaplastic large cell lymphoma (ALCL). | ||||
| Specific Marker | MDD/MRD |
Patients
Positive (%) |
Clinical
Relevance |
Specific Marker |
| RT-PCR for NPM–ALK Transcripts (RNA) | MDD MRD |
50–60 25 |
HR patients (50% EFS), validated [44,45,46,48,50] VHR patients (25% EFS), validated [46,53] |
RT-PCR for NPM–ALK transcripts (RNA) |
| RQ-PCR or dPCR for NPM–ALK Transcripts (RNA) | MDD MRD |
20–25 | VHR patients (30% EFS) [44,50] Individual response to therapy [54,55,56,57,70] |
RQ-PCR or dPCR for NPM–ALK transcripts (RNA) |
n.k. not known; ctDNA, circulating tumor DN;, QC, quality control; HR, high relapse risk; VHR, very high relapse risk.