minimal residual disease detection using gene scanning analysis, fluorescent fragment analysis, and capillary electrophoresis for igh rearrangement in adult b-lineage acute lymphoblastic leukemia: a cross-sectional study

Objective: minimal residual disease (mrd) is considered the greatest prognostic factor in acute lymphoblastic leukemia(all). mrd is a valuable tool for anticipating impending relapse and treatment response assessment. the objective ofthe present study was to investigate whether the detection of igh gene rearrangement using polymerase chain reaction(pcr)-based genescan analysis could be a complementary method to monitor mrd along with the quantitative realtimepcr (qpcr).materials and methods: in this cross-sectional study, we valued the mrd levels, based on the genescanning analysis(gsa), and then compared the data with quantitative real-time polymerase chain reaction at different time points inperipheral blood (pb) samples of adult b-lineage all patients (n=35). the specific polymerase chain reaction (pcr)primers for igh gene fr-1 and fluorescence-labeled j-primer were used and analyzed by capillary gel electrophoresison a sequencer. the results of this study were compared with the previously reported mrd results obtained by the ighrearrangements allele-specific oligonucleotide (aso) -qpcr methods.results: the total concordance rate was 86.7%, with a p<0.001. mrd results obtained by gsa and aso-qpcr methodswere concordant in all diagnostic samples and samples on the 14th and 28th days of induction therapy. the results of these 2.5years’ follow-ups demonstrated a significant correlation between the two techniques (r=0.892, p<0.001).conclusion: it seems that the pcr-based genescan analysis of igh gene rearrangement detection may be a valuablemolecular technique to distinguish monoclonality from polyclonality. and also, it may be a precise tool to detect theresidual leukemic dna in the pb follow-up samples of patients.