Molecular Detection of Tyrosine Hydroxylase in the Peripheral Blood of Patients with Neuroblastoma: Useful at Diagnosis but not Predictive of Subsequent Relapse During Off-Therapy Follow-Up

Abstract

In the present study, the authors analyzed the tyrosine hydroxylase (TH) expression in peripheral blood (PB) of neuroblastoma (NB) patients and investigated the clinical implications. From April 2005 to October 2008, a total of 683 PB specimens (64 at diagnosis, 244 during chemotherapy, 355 during off-therapy follow-up, and 20 at relapse) acquired from 141 patients were investigated. TH expression was measured by quantitative reverse transcriptase-polymerase chain reaction (RTPCR). TH-positive rate at diagnosis (21.4%) was higher than those during chemotherapy (0.8%) or off-therapy follow-up (1.7%). TH expression at diagnosis was associated with high-risk features (ie, advanced stage, older age, unfavorable pathology, and amplified N-myc) and the probability of 3-year relapse-free survival in the TH-positive patients was lower than in the TH-negative patients (45.8% +/- 27.8% versus 95.8% +/- 5.7%, P < .001). TH expression was positive in only 6 specimens during off-therapy follow-up. However, tumor relapse occurred in only 2 out of 6 TH-positive patients. In addition, TH expression was negative during previous off-therapy follow-up, prior to relapse, in 8 out of 10 relapsed patients. Whereas TH expression in PB at diagnosis was associated with high-risk features and a poorer outcome, TH expression during off-therapy follow-up had very limited value for the prediction of a subsequent relapse.