Relationship of Initial Total Count of White Blood Cell with Post-Induction MRD in Children with Acute Lymphoblastic Leukaemia

Background: Minimal Residual Disease (MRD) following chemotherapy is one of the strongest independent prognostic markers for Acute Lymphoblastic Leukaemia (ALL). Patients with detectable MRD have an increased risk of relapse. There is significant relationship of MRD with other prognostic factors. But this relationship has not been fully evaluated in paediatric patients with ALL. So, the aim of this study is to determine the relationship of initial total count of WBC with MRD at the end of induction. Methodology: This prospective cross-sectional study was conducted in the Department of Paediatric Haematology & Oncology, Dhaka Medical College Hospital (DMCH), from May 2022 to April 2023. A total of thirty children diagnosed with ALL of both sexes between 1 and 19 years who received induction chemotherapy were included in this study. MRD was done at D29 of induction from bone marrow by reverse transcription polymerase chain reaction (RT-PCR) method. Results: This study found that 33.3% patient developed positive MRD. The study showed that significant positive correlation between the initial total count of WBC and MRD level. The analysis also showed a significant relationship between high-risk group, patients receiving regimen B and M3 category bone marrow with MRD (p<0.001). Conclusion: There is significant positive correlation between the initial total count of WBC and MRD level. There is also a significant association with post induction MRD positivity with high-risk group, use of regimen B and patients with M3 marrow.