Division of Pediatric Hematology/Oncology, Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas, USA.
Department of Biostatistics, Colleges of Medicine, Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
Pediatr Blood Cancer. 2021 Apr;68(4):e28929. doi: 10.1002/pbc.28929. Epub 2021 Feb 9.
The 5-year disease-free survival (DFS) of National Cancer Institute (NCI) high-risk (HR) B-lymphoblastic leukemia (B-ALL) patients with end of induction (EOI) minimal residual disease (MRD) ≥0.1% and end of consolidation (EOC) MRD ≥0.01% is 39 ± 7%, warranting consideration of hematopoietic stem cell transplant (HSCT). However, the impact of EOC MRD in NCI standard-risk (SR) B-ALL patients using COG regimens is unknown. We found that SR patients with MRD ≥0.01% at both EOI and EOC have a 4-year DFS/overall survival (OS) of 72.9 ± 19.0%/91.7 ± 10.8% versus 90.7 ± 2.9%/95.5 ± 2.0% (p = .0019/.25) for those with EOI MRD ≥0.01% and EOC MRD <0.01%. These data suggest that routine use of HSCT may not be warranted in EOC MRD ≥0.01% SR patients.
美国国家癌症研究所（NCI）高危（HR）B 淋巴细胞白血病（B-ALL）患者在诱导结束（EOI）时微小残留病（MRD）≥0.1%和巩固结束（EOC）时 MRD≥0.01%的 5 年无病生存率（DFS）为 39±7%，需要考虑造血干细胞移植（HSCT）。然而，COG 方案治疗 NCI 标准风险（SR）B-ALL 患者中 EOC MRD 的影响尚不清楚。我们发现，EOI 和 EOC 时 MRD≥0.01%的 SR 患者的 4 年 DFS/总生存率（OS）分别为 72.9±19.0%/91.7±10.8%和 90.7±2.9%/95.5±2.0%（p=0.0019/0.25），而 EOI MRD≥0.01%和 EOC MRD<0.01%的患者。这些数据表明，对于 EOC MRD≥0.01%的 SR 患者，常规使用 HSCT 可能没有必要。
