{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T07:13:07Z","timestamp":1763968387228,"version":"3.41.2"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,25]],"date-time":"2020-01-25T00:00:00Z","timestamp":1579910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA014089"],"award-info":[{"award-number":["P30CA014089"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Accurate disease detection is integral to risk stratification in B\u2010cell acute lymphoblastic leukemia (ALL). The gold standard used to evaluate response in the United States includes morphologic evaluation and minimal residual disease (MRD) testing of aspirated bone marrow (BM) by flow cytometry (FC). This MRD assessment is usually made on a single aspirate sample that is subject to variability in collection techniques and sampling error. Additionally, central nervous system (CNS) assessments for ALL include evaluations of cytopathology and cell counts, which can miss subclinical involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We retrospectively compared BM biopsy, aspirate, and FC samples obtained from children and young adults with relapsed\/refractory ALL to identify the frequency and degree of disease discrepancies in this population. We also compared CNS FC and cytopathology techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty of 410 (14.6%) BM samples had discrepant results, 41 (10%) of which were clinically relevant as they resulted in a change in the assignment of marrow status. Discrepant BM results were found in 28 of 89 (31.5%) patients evaluated. Additionally, cerebrospinal fluid (CSF) FC identified disease in 9.7% of cases where cytopathology was negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results support further investigation of the role of concurrent BM biopsy, with aspirate and FC evaluations, and the addition of FC to CSF evaluations, to fully assess disease status and response, particularly in patients with relapsed\/refractory ALL. Prospective studies incorporating more comprehensive analysis to evaluate the impact on clinical outcomes are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28149","type":"journal-article","created":{"date-parts":[[2020,1,25]],"date-time":"2020-01-25T11:40:26Z","timestamp":1579952426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Disease detection methodologies in relapsed B\u2010cell acute lymphoblastic leukemia: Opportunities for improvement"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8692-8034","authenticated-orcid":false,"given":"Haneen","family":"Shalabi","sequence":"first","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constance M.","family":"Yuan","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology CCR, NCI, NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amita","family":"Kulshreshtha","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Dulau\u2010Florea","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Clinical Center Hematology Section, NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalia","family":"Salem","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology CCR, NCI, NIH  Bethesda Maryland"},{"name":"Mansoura University Faculty of Medicine Clinical Pathology  Mansoura Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Clinical Center Hematology Section, NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Roth","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology CCR, NCI, NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando C.","family":"Filie","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology CCR, NCI, NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonnie","family":"Yates","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"Delbrook","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Derdak","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crystal L.","family":"Mackall","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"},{"name":"Cancer Immunology and Immunotherapy Program Stanford University, Stanford, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel W.","family":"Lee","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"},{"name":"Division of Pediatric Hematology\/Oncology, Department of Pediatrics University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry J.","family":"Fry","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"},{"name":"Division of Human Immunology and Immunotherapy Initiative, Pediatric Hematology\/Oncology Children's Hospital of Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan S.","family":"Wayne","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"},{"name":"Children's Center for Cancer and Blood Diseases, Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Norris Comprehensive Cancer Center, Keck School of Medicine University of Southern California  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryalice","family":"Stetler\u2010Stevenson","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology CCR, NCI, NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-9080","authenticated-orcid":false,"given":"Nirali N.","family":"Shah","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research (CCR) National Cancer Institute (NCI), NIH  Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-018-0039-7"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.6278"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110169"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-633685"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-01-132837"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1043878"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.4774"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000261909.28915.83"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-010-1145-4"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPANA7ER1ABMZI"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.21482"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpcy.44"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20429"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199307293290504"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/0471142956.cy0625s45"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.101741"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21243"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-580027"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-07-2708"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2017.07.002"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2010.03.002"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-018-0039-7"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2014.955020"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2015.089"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2014.0018"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2016.12.004"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2017.12.646"},{"key":"e_1_2_9_29_1","first-page":"46","article-title":"Multiple relapses in extramedullary localization of acute lymphoblastic leukemia","volume":"113","author":"Kosucu P","year":"2012","journal-title":"Bratisl Lek Listy"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2405072"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26128"},{"key":"e_1_2_9_32_1","first-page":"1","article-title":"Cerebrospinal fluid analysis by 8\u2010color flow cytometry in children with acute lymphoblastic leukemia","volume":"2019","author":"Gabelli M","journal-title":"Leuk Lymphoma"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2001.02505.x"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-5970-8"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.49.3.249"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.28149","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.28149","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.28149","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.28149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T03:17:05Z","timestamp":1693970225000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.28149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,25]]},"references-count":34,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1002\/pbc.28149"],"URL":"https:\/\/doi.org\/10.1002\/pbc.28149","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"type":"print","value":"1545-5009"},{"type":"electronic","value":"1545-5017"}],"subject":[],"published":{"date-parts":[[2020,1,25]]},"assertion":[{"value":"2019-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e28149"}}