Harlan Robins

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Deep sequencing for minimal residual disease detection in Acute Lymphoblastic Leu

The assessment of minimal residual disease in acute lymphoblastic leukemia (ALL) is critical for optimizing and individualizing patient-specific chemotherapy and clinical outcome. Recently, we demonstrated the first application of next-generation sequencing to the diagnosis of minimal residual disease in acute lymphoblastic leukemia. In this study [1], we showed, using 43 paired pre- and post-treatment samples from an ongoing Children's Oncology Group (COG) T-ALL clinical trial, that high-throughput sequencing of T cell receptor gene rearrangements could improve the detection of minimal residual disease as compared to flow cytometry, the current clinical standard of care within the United States. As the development of a robust, standardized method for stratifying patients with ALL in the post-therapy setting is important for advancing the potential clinical implementation of this technology, we propose to critically evaluate the clinical sensitivity and specificity of high throughput sequencing of immunoglobulin and T-cell receptor gene repertoire in acute lymphoblastic leukemia.