TY - JOUR AU - Del Principe, Maria Ilaria AU - Buzzatti, Elisa AU - Piciocchi, Alfonso AU - Forghieri, Fabio AU - Bonifacio, Massimiliano AU - Lessi, Federica AU - Imbergamo, Silvia AU - Orciuolo, Enrico AU - Rossi, Giovanni AU - Fracchiolla, Nicola AU - Trappolini, Silvia AU - Neri, Benedetta AU - Sarlo, Chiara AU - Zappasodi, Patrizia AU - Dargenio, Michelina AU - Cefalo, Mariagiovanna AU - Irno-Consalvo, Maria Antonietta AU - Conti, Consuelo AU - Paterno, Giovangiacinto AU - De Angelis, Gottardo AU - Sciumè, Mariarita AU - Della Starza, Irene AU - Venditti, Adriano AU - Foà, Robin AU - Guarini, Anna Rita PY - 2021/01/01 Y2 - 2024/03/29 TI - Clinical significance of occult central nervous system disease in adult acute lymphoblastic leukemia. A multicenter report from the Campus ALL Network JF - Haematologica JA - haematol VL - 106 IS - 1 SE - Articles DO - 10.3324/haematol.2019.231704 UR - https://haematologica.org/article/view/9587 SP - 39-45 AB - In acute lymphoblastic leukemia, flow cytometry detects more accurately leukemic cells in patients' cerebrospinal fluid compared to conventional cytology. However, the clinical significance of flow cytometry positivity with a negative cytology - occult central nervous system disease - is not clear. In the framework of the national Campus ALL program, we retrospectively evaluated the incidence of occult central nervous system disease and its impact on outcome in 240 adult patients with newly diagnosed acute lymphoblastic leukemia. All cerebrospinal fluid samples were investigated by conventional cytology and flow cytometry. The presence of ≥10 phenotypically abnormal events, forming a cluster, was considered as flow cytometry positivity. No central nervous system involvement was documented in 179 patients, while 18 were positive by conventional morphology and 43 were occult central nervous system disease positive. The relapse rate was significantly lower in central nervous system disease negative patients and the disease-free and overall survival were significantly longer in central nervous system disease negative patients than in those with manifest or occult central nervous system disease positive. In multivariate analysis, the status of manifest and occult central nervous system disease positivity was independently associated with a worse overall survival. In conclusion, we demonstrate that in adult acute lymphoblastic leukemia patients at diagnosis flow cytometry can detect occult central nervous system disease at high sensitivity and that the status of occult central nervous system disease positivity is associated with an adverse outcome. (Clinicaltrials.gov NCT03803670) ER -