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基于费城染色体阳性急性淋巴细胞白血病拷贝数的 MRD 监测的预后价值。

Prognostic value of MRD monitoring based on copy numbers in Philadelphia chromosome positive acute lymphoblastic leukemia.

机构信息

Department of Hematology, Christian Medical College, Vellore, India.

出版信息

Leuk Lymphoma. 2020 Dec;61(14):3468-3475. doi: 10.1080/10428194.2020.1811272. Epub 2020 Aug 27.

Abstract

Assessment of measurable residual disease (MRD) has emerged as a powerful prognostic tool in pediatric and adult acute lymphoblastic leukemia (ALL). In this single-centre retrospective study, we evaluated the prognostic relevance of MRD based on copy numbers in Ph + ALL patients between 2006 and 2018. Molecular responses were evaluated at 3, 6, 9 and 12 months after the initiation of treatment. Patients who had their MRD assessed at three or more time points were categorized into MRD good risk or poor risk based on copy number ratio. MRD positive patients consistently showed a trend toward poor survival and on multivariate analysis, MRD poor risk patients had adverse outcomes when compared to MRD good risk patients in terms of overall (OS;  = .031) and event-free (EFS;  < .001) survival. In conclusion, molecular MRD based on copy number ratio is an ideal prognostic indicator in Ph + ALL patients undergoing treatment.

摘要

在儿科和成人急性淋巴细胞白血病(ALL)中,可测量残留疾病(MRD)的评估已成为一种强大的预后工具。在这项单中心回顾性研究中,我们评估了基于 2006 年至 2018 年间 Ph+ALL 患者拷贝数的 MRD 的预后相关性。在治疗开始后 3、6、9 和 12 个月评估分子反应。根据拷贝数比值,对至少评估了三个时间点 MRD 的患者进行 MRD 低危或高危分类。MRD 阳性患者的生存趋势一直较差,多变量分析显示,与 MRD 低危患者相比,MRD 高危患者的总生存(OS;=0.031)和无事件生存(EFS;<0.001)结局不良。总之,基于拷贝数比值的分子 MRD 是接受治疗的 Ph+ALL 患者的理想预后指标。

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