ArticleLeukemia2018
Flow-cytometric vs. -morphologic assessment of remission in childhood acute lymphoblastic leukemia: a report from the Children's Oncology Group (COG).
Article in Leukemia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 58 citations in OpenAlex.
- Trial
- Morphologic remission status is limited compared to ΔN flow cytometry: a Children's Oncology Group AAML0531 report.Blood advances · 2020Trial
- Outcome in Children With Standard-Risk B-Cell Acute Lymphoblastic Leukemia: Results of Children's Oncology Group Trial AALL0331.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Trial
- Diagnostic profile of Pediatric T-Lymphoblastic Leukemia and its correlation with post-induction disease status.Pakistan journal of medical sciences · 2026Article
- Reporting blast percentage for response assessment in acute leukemias: recommendations from an EHA/ELN expert panel.Haematologica · 2026Article
- Results in pediatric T-ALL patients treated in trial AIEOP-BFM ALL 2009: Prognostic factors in the context of modern risk-adapted therapy.HemaSphere · 2025Article
- Analysis of Antigen Expression in T-Cell Acute Lymphoblastic Leukemia by Multicolor Flow Cytometry: Implications for the Detection of Measurable Residual Disease.International journal of molecular sciences · 2025Article
- A potential prognostic marker for hematologic neoplasms: CD58.Frontiers in oncology · 2025Review
- Mechanism of action, potency and efficacy: considerations for cell therapies.Journal of translational medicine · 2024Review
- Prognostic implications of CD9 in childhood acute lymphoblastic leukemia: insights from a nationwide multicenter study in China.Leukemia · 2024Article
- One-point flow cytometric MRD measurement to identify children with excellent outcome after intermediate-risk BCP-ALL: results of the ALL-MB 2008 study.Journal of cancer research and clinical oncology · 2023Article
- Article
- Utility of Bone Marrow Examination in Pediatric Age Group: Experience of a Tertiary Healthcare Centre in India.Cureus · 2022Article
- Article
- Targeting pediatric leukemia-propagating cells with anti-CD200 antibody therapy.Blood advances · 2021Article
- Multiparametric Flow Cytometry for MRD Monitoring in Hematologic Malignancies: Clinical Applications and New Challenges.Cancers · 2021Review
- Article
- Minimal Residual Disease Prior to and After Haematopoietic Stem Cell Transplantation in Children and Adolescents With Acute Lymphoblastic Leukaemia: What Level of Negativity Is Relevant?Frontiers in pediatrics · 2021Review
- Disease detection methodologies in relapsed B-cell acute lymphoblastic leukemia: Opportunities for improvement.Pediatric blood & cancer · 2020Article
- Label-Free Leukemia Monitoring by Computer Vision.Cytometry. Part A : the journal of the International Society for Analytical Cytology · 2020Article
Corrections and comments
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Authors and funding
20 authors at 15 institutions in 2 countries.
Funding
Abstract
Minimal residual disease (MRD) after initial therapy is integral to risk stratification in B-precursor and T-precursor acute lymphoblastic leukemia (B-ALL, T-ALL). Although MRD determines depth of remission, remission remains defined by morphology. We determined the outcomes of children with discordant assessments of remission by morphology vs. flow cytometry using patients age 1-30.99 years enrolled on Children's Oncology Group ALL trials who underwent bone marrow assessment at the end of induction (N = 9350). Morphologic response was assessed locally as M1 (<5% lymphoblasts; remission), M2 (5-25%), or M3 (>25%). MRD was centrally measured by flow cytometry. Overall, 19.8% of patients with M2/M3 morphology had MRD < 5%. M1 with MRD ≥ 5% was less common in B-ALL (0.9%) than T-ALL (6.9%; p < 0.0001). In B-ALL, M1/MRD ≥ 5% was associated with superior 5-year event-free survival (EFS) than M2/MRD ≥ 5% (59.1% ± 6.5% vs. 39.1% ± 7.9%; p = 0.009), but was inferior to M1/MRD < 5% (87.1% ± 0.4%; p < 0.0001). MRD levels were higher in M2/MRD ≥ 5% than M1/MRD ≥ 5% patients. In T-ALL, EFS was not significantly different between M1/MRD ≥ 5% and M2/MRD ≥ 5%. Patients with morphologic remission but MRD ≥ 5% have outcomes similar to those who fail to achieve morphological remission, and significantly inferior to those with M1 marrows and concordant MRD, suggesting that flow cytometry should augment the definition of remission in ALL.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.