Increased risk of systemic relapses associated with bone marrow micrometastasis and circulating XXXX cells in localized ewing @entity5 .

@entity1 @entity2828 @entity1263 @entity5 @entity3 @entity12726
PURPOSE: The presence of @entity3 is a major prognostic factor in @entity2828 ( @entity2828 ). The relapse pattern of @entity1 with @entity5 has long indicated that cases with disseminated @entity2828 cells escape detection at diagnosis. @entity2828 cells are characterized by specific gene fusions that can be detected with high sensitivity and specificity by reverse transcriptase polymerase chain reaction (RT-PCR). @entity1 AND METHODS: RT-PCR targeting @entity12726 or EWS-ERG transcripts was used to search for @entity5 cells in peripheral blood (PB) and bone marrow (BM) at diagnosis in 172 @entity1 with @entity2828 , and the prognostic significance of this parameter was assessed. RESULTS: As we suggested previously in a smaller series of @entity1 , RT-PCR positivity of the BM was correlated with a high risk of adverse outcome in the overall study population (P =.007). More interestingly, among @entity1 with otherwise @entity5 , BM micrometastasis also predicted significantly poorer disease-free survival rates (P =.043). The presence of circulating @entity5 cells (CTC) was more frequently observed in @entity1 with large @entity5 (P =.006). CTC were associated with a poor outcome among @entity1 with clinically localized disease (P =.045). @entity1 with clinically localized disease and @entity1263 cells as evidenced by BM and/or PB RT-PCR positivity had @entity5 and experienced relapses at a systemic rather than at a local level. CONCLUSION: @entity1 with localized @entity2828 and BM micrometastasis or CTC are comparable to @entity1 with @entity3 in terms of the localization of the @entity5 , outcome, and relapse pattern.
