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We investigated the value of our proprietary approach\u2014cell surface vimentin (CSV) positive circulating tumor cells (CTC) to monitor treatment response and predict relapse in NB patients under remission in a Phase II long\u2010term preventative clinical trial. We longitudinally analyzed peripheral blood samples from 93 patients for 27\u2009cycles (~25\u2009months) and discovered that the presence of CSV<jats:sup>+<\/jats:sup> CTCs in the first two sequential samples (baseline, cycle 4 [month 3\u20104]) was a significant indicator of earlier relapse. We observed strong correlation between relapse\u2010free survival (RFS) and lack of CSV<jats:sup>+<\/jats:sup> CTCs in first 4 cycles of therapy (95%). There was sensitivity reaching 100% in predicting RFS in patients who had neither CSV<jats:sup>+<\/jats:sup> CTCs nor MycN amplification. Of note, the low number of CSV<jats:sup>+<\/jats:sup> CTCs seems equivalent to low tumor load because the prevention therapy difluoromethylornithine yields faster reduction of relapse risk when none or only 1\u20102 CSV<jats:sup>+<\/jats:sup> CTCs (every 6 mL) are present in the blood samples compared to &gt;3 CSV<jats:sup>+<\/jats:sup> CTCs. To the best of our knowledge, this is the first study that directly observes CTCs in under remission NB patients for relapse prediction and the first to gather sequential CSV<jats:sup>+<\/jats:sup> CTC data in any study in a long\u2010term longitudinal manner.<\/jats:p>","DOI":"10.1002\/ijc.33140","type":"journal-article","created":{"date-parts":[[2020,6,7]],"date-time":"2020-06-07T15:08:51Z","timestamp":1591542531000},"page":"3550-3559","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Cell surface vimentin\u2010positive circulating tumor cell\u2010based relapse prediction in a long\u2010term longitudinal study of postremission neuroblastoma patients"],"prefix":"10.1002","volume":"147","author":[{"given":"Izhar S.","family":"Batth","sequence":"first","affiliation":[{"name":"Department of Pediatrics The University of Texas MD Anderson Cancer Center  Houston Texas 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