Higher levels of minimal residual disease in peripheral blood than bone marrow before 1st and 2nd relapse/regrowth in a patient with high‑risk neuroblastoma: A case report

Inoue,Shotaro; Nay Win,Kaung Htet; Mon,Cho Yee; Fujikawa,Tomoko; Hyodo,Sayaka; Uemura,Suguru; Ishida,Toshiaki; Mori,Takeshi; Hasegawa,Daiichiro; Kosaka,Yoshiyuki; Nishimura,Akihiro; Nakatani,Naoko; Nino,Nanako; Tamura,Akihiro; Yamamoto,Nobuyuki; Nozu,Kandai; Nishimura,Noriyuki

doi:10.3892/ol.2023.13955

Higher levels of minimal residual disease in peripheral blood than bone marrow before 1st and 2nd relapse/regrowth in a patient with high‑risk neuroblastoma: A case report

Authors:
- Shotaro Inoue
- Kaung Htet Nay Win
- Cho Yee Mon
- Tomoko Fujikawa
- Sayaka Hyodo
- Suguru Uemura
- Toshiaki Ishida
- Takeshi Mori
- Daiichiro Hasegawa
- Yoshiyuki Kosaka
- Akihiro Nishimura
- Naoko Nakatani
- Nanako Nino
- Akihiro Tamura
- Nobuyuki Yamamoto
- Kandai Nozu
- Noriyuki Nishimura
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Affiliations: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan, Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Hyogo 654‑0142, Japan, Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650‑0047, Japan
Published online on: July 14, 2023 https://doi.org/10.3892/ol.2023.13955
Article Number: 369

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Abstract

More than half of patients with high‑risk neuroblastoma (HR‑NB) experience relapse/regrowth due to the activation of chemoresistant minimal residual disease (MRD). MRD in patients with HR‑NB can be evaluated by quantitating neuroblastoma‑associated mRNAs (NB‑mRNAs) in bone marrow (BM) and peripheral blood (PB) samples. Although several sets of NB‑mRNAs have been shown to possess a prognostic value for MRD in BM samples (BM‑MRD), MRD in PB samples (PB‑MRD) is considered to be low and difficult to evaluate. The present report describes an HR‑NB case presenting higher PB‑MRD than BM‑MRD before 1st and 2nd relapse/regrowth. A 3‑year‑old female presented with an abdominal mass, was diagnosed with HR‑NB, and treated according to the nationwide standard protocol for HR‑NB. Following systemic induction and consolidation therapy with local therapy, the patient achieved complete remission but experienced a 1st relapse/regrowth 6 months after maintenance therapy. The patient partially responded to salvage chemotherapy and anti‑GD2 immunotherapy but had a 2nd relapse/regrowth 14 months after the 1st relapse/regrowth. Consecutive PB‑MRD and BM‑MRD monitoring revealed that PB‑MRD was lower than BM‑MRD at diagnosis (100 times) and 1st and 2nd relapse/regrowth (1,000 and 3 times) but became higher than BM‑MRD before 1st and 2nd relapse/regrowth. The present case highlights that PB‑MRD can become higher than BM‑MRD before relapse/regrowth of patients with HR‑NB.

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