Rotchanapanya Wannaphorn, Hokland Peter, Tunsing Pattaraporn, Owattanapanich Weerapat
Division of Hematology, Department of Medicine, Chiangrai Prachanukroh Hospital, Chiang Rai 57000, Thailand.
Division of Hematology, Department of Clinical Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark.
J Pers Med. 2020 Nov 26;10(4):250. doi: 10.3390/jpm10040250.
Measurable residual disease (MRD) response during acute myeloid leukemia (AML) treatment is a gold standard for determining treatment strategy, especially in core-binding factor (CBL) AML. The aim of this study was to critically review the literature on MRD status in the CBF-AML to determine the overall impact of MRD status on clinical outcomes. Published studies in the MEDLINE and EMBASE databases from their inception up to 1 June 2019 were searched. The primary end-point was either overall survival (OS) or recurrence-free survival (RFS) between MRD negative and MRD positive CBF-AML patients. The secondary variable was cumulative incidence of relapse (CIR) between groups. Of the 736 articles, 13 relevant studies were included in this meta-analysis. The MRD negative group displayed more favorable recurrence-free survival (RFS) than those with MRD positivity, with a pooled odds ratio (OR) of 4.5. Moreover, OS was also superior in the MRD negative group, with a pooled OR of 7.88. Corroborating this, the CIR was statistically significantly lower in the MRD negative group, with a pooled OR of 0.06. The most common cutoff MRD level was 1 × 10. These results suggest that MRD assessment should be a routine investigation in clinical practice in this AML subset.
急性髓系白血病（AML）治疗期间的可测量残留病（MRD）反应是确定治疗策略的金标准，尤其是在核心结合因子（CBF）AML中。本研究的目的是严格回顾关于CBF-AML中MRD状态的文献，以确定MRD状态对临床结局的总体影响。检索了MEDLINE和EMBASE数据库中从建库至2019年6月1日发表的研究。主要终点是MRD阴性和MRD阳性CBF-AML患者之间的总生存期（OS）或无复发生存期（RFS）。次要变量是两组之间的累积复发率（CIR）。在736篇文章中，13项相关研究纳入了本荟萃分析。MRD阴性组的无复发生存期（RFS）比MRD阳性组更有利，合并优势比（OR）为4.5。此外，MRD阴性组的OS也更优，合并OR为7.88。与此相符的是，MRD阴性组的CIR在统计学上显著更低，合并OR为0.06。最常见的MRD水平临界值为1×10。这些结果表明，MRD评估应成为该AML亚组临床实践中的常规检查。
