Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584CS, The Netherlands.
Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, The Netherlands.
Expert Rev Anticancer Ther. 2021 Apr;21(4):451-459. doi: 10.1080/14737140.2021.1860763. Epub 2021 Mar 11.
: A systematic review was performed to assess the prognostic value of Measurable Residual Disease (MRD) during treatment, for relapse and overall survival in pediatric acute myeloid leukemia (AML).: A systematic search of available literature was performed to identify original full-text articles concerning MRD as prognostic for relapse and survival in pediatric AML. Thirteen studies were included, and in all studies, MRD positivity during treatment was associated with worse clinical outcome. MRD positivity was significantly associated with a higher probability of relapse in eleven studies. However, MRD negativity does not exclude the possibility of relapse in pediatric AML, while positivity early during therapy does not exclude cure.: MRD positivity during treatment has emerged as the most powerful prognostic factor in pediatric AML concerning relapse and overall survival and is useful for risk-group adapted treatment. Future studies should identify the optimal time-point(s) for MRD measurements and the optimal technique, to further improve its prognostic significance.
一项系统评价评估了治疗期间可测量残留疾病（MRD）对儿童急性髓系白血病（AML）复发和总生存的预后价值。对可获得的文献进行了系统搜索，以确定有关 MRD 作为儿童 AML 复发和生存预后的原始全文文章。共纳入 13 项研究，在所有研究中，治疗期间的 MRD 阳性与更差的临床结局相关。MRD 阳性在 11 项研究中与更高的复发概率显著相关。然而，MRD 阴性并不能排除儿童 AML 复发的可能性，而早期治疗中的阳性并不能排除治愈的可能性。治疗期间的 MRD 阳性已成为与儿童 AML 复发和总体生存相关的最有力的预后因素，对风险组适应性治疗有用。未来的研究应确定用于进一步提高其预后意义的最佳 MRD 测量时间点和最佳技术。
