Liu K Q, Wei H, Lin D, Wang Y, Zhou C L, Liu B C, Li X L, Zhao Y, Li H J, Wang C W, Li Q H, Li B F, Gong Y T, Liu X Y, Gong Y C, Mi J X, Wang Jianxiang
Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2018 Sep 14;39(9):724-728. doi: 10.3760/cma.j.issn.0253-2727.2018.09.004.
To explore the predictive value of minimal residual disease (MRD) level in Ph-negative precursor B-acute lymphoblastic leukemia (ALL) patients. 193 Ph-negative B-ALL patients from Sep 2010 to Nov 2017 were involved in the study. The patients' MRD evaluation which can be performed by multiparametric flow cytometry (MFC) after 1 month, 3-month, 6-month treatment. Relapse free survival (RFS) and overall survival (OS) were compared in patients with different MRD level. The median follow-up was 22 months. All patients was evaluated at 497 MRD level. Patients who reach the good MRD level at 1 month (<0.1% or ≥0.1%), 3-month (negative or positive), 6-month (negative or positive) had a significantly higher probability of estimated RFS (74.5% 29.9%; 75.6% 29.7%; 74.6% 11.6%) and of estimated OS (67.5% 30.3%; 71.6% 27.8%; 74.0% 15.7%). Patients who reach the MRD negative at all 3 times had a significantly higher probability of estimated RFS (80.5% 30.5%) and better estimated OS (77.1% 29.4%) compared to patients with at least MRD failure in one time (<0.001). Multivariable analysis showed MRD level at 3-month was an independent prognostic factor for DFS and OS. MRD is an important prognosis factor for Ph-negative B- ALL patients.
探讨微小残留病（MRD）水平对Ph阴性前体B淋巴细胞白血病（ALL）患者的预测价值。本研究纳入了2010年9月至2017年11月期间的193例Ph阴性B-ALL患者。患者在治疗1个月、3个月、6个月后可通过多参数流式细胞术（MFC）进行MRD评估。比较了不同MRD水平患者的无复发生存期（RFS）和总生存期（OS）。中位随访时间为22个月。共对所有患者进行了497次MRD水平评估。在1个月时达到良好MRD水平（<0.1%或≥0.1%）、3个月时（阴性或阳性）、6个月时（阴性或阳性）的患者，其估计RFS（74.5%对29.9%；75.6%对29.7%；74.6%对11.6%）和估计OS（67.5%对30.3%；71.6%对27.8%；74.0%对15.7%）的概率显著更高。与至少有一次MRD未达标的患者相比，三次均达到MRD阴性的患者估计RFS（80.5%对30.5%）的概率显著更高，估计OS（77.1%对29.4%）也更好（<0.001）。多变量分析显示治疗3个月时的MRD水平是DFS和OS的独立预后因素。MRD是Ph阴性B-ALL患者的重要预后因素。
