Xue Yu-Juan, Lu Ai-Dong, Wang Yu, Jia Yue-Ping, Zuo Ying-Xi, Zhang Le-Ping
Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China.
Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Oct;31(5):1303-1308. doi: 10.19746/j.cnki.issn.1009-2137.2023.05.008.
To explore the consistency of flow cytometry (FCM) method and polymerase chain reaction (PCR) technique in the detection of minimal residual disease (MRD) at different treatment stages in pediatric patients with B-cell acute lymphoblastic leukemia (B-ALL) and the correlations between the detection results and prognosis.
The clinical data of 64 newly diagnosed pediatric patients with B-ALL admitted to the Department of Pediatrics of Peking University People's Hospital from January 2005 to December 2017 were retrospectively analyzed. FCM and PCR methods were used to monitor the MRD level in bone marrow samples from 64 children during the same period of treatment on d33 and d90 respectively, and the detection results were analyzed.
There were 37 males and 27 females in the 64 patients, with a median age of 8 years(range 0.8 to 16 years). The complete remission (CR) rate after the first cycle of induction chemotherapy was 98.4% (62/63), with overall CR rate of 100%. 12 patients experienced recurrence, with a median recurrence time of 16.9 (5.3-46.3) months. The median follow-up time of the 64 patients was 77.2 (1.0-184.8) months , and the 5-year overall survival (OS) rate and event-free survival (EFS) rate were 82.8%±4.7% and 75.0%±5.4%, respectively. On d90, the concordance rate of the MRD results from the two methods was 98.4%, and the related kappa value was 0.792 ( < 0.001), which were significantly higher than those on d33. After induction chemotherapy (d33), the 5-year EFS rate of MRD-FCM group (79.3%±5.3%) was significantly better than that of MRD-FCM group (40.0%±21.9%) ( =0.028), there were no significant differences in the 5-year OS rate and EFS rate between MRD-PCR group and MRD-PCR group, and the 5-year EFS rate of MRD-FCM/PCR group (85.4%±5.5%) was significantly better than that of MRD-FCM/PCR group (40.0 %±21.9%) ( =0.026).
In children with B-ALL, the MRD results detected by FCM and PCR methods show good consistency, especially in consolidation therapy period (d90). The MRD level at the end of induction therapy (d33) is an important factor affecting the long-term prognosis, especially the MRD results detected by FCM method, which is significantly associated with prognosis.
探讨流式细胞术（FCM）法与聚合酶链反应（PCR）技术在检测小儿B细胞急性淋巴细胞白血病（B-ALL）不同治疗阶段微小残留病（MRD）中的一致性，以及检测结果与预后的相关性。
回顾性分析2005年1月至2017年12月北京大学人民医院儿科收治的64例新诊断小儿B-ALL患者的临床资料。采用FCM和PCR方法分别监测64例患儿在治疗同期第33天和第90天骨髓样本中的MRD水平，并对检测结果进行分析。
64例患者中男性37例，女性27例，中位年龄8岁（范围0.8至16岁）。诱导化疗第1周期后的完全缓解（CR）率为98.4%（62/63），总CR率为100%。12例患者复发，中位复发时间为16.9（5.3 - 46.3）个月。64例患者的中位随访时间为77.2（1.0 - 184.8）个月，5年总生存（OS）率和无事件生存（EFS）率分别为82.8%±4.7%和75.0%±5.4%。在第90天，两种方法的MRD结果一致性率为98.4%，相关kappa值为0.792（<0.001），均显著高于第33天。诱导化疗后（第33天），MRD-FCM组的5年EFS率（79.3%±5.3%）显著优于MRD-FCM组（40.0%±21.9%）（P =0.028），MRD-PCR组与MRD-PCR组的5年OS率和EFS率无显著差异，MRD-FCM/PCR组的5年EFS率（85.4%±5.5%）显著优于MRD-FCM/PCR组（40.0 %±21.9%）（P =0.026）。
在小儿B-ALL中，FCM和PCR方法检测的MRD结果显示出良好的一致性，尤其是在巩固治疗期（第90天）。诱导治疗结束时（第33天）的MRD水平是影响长期预后的重要因素，尤其是FCM法检测的MRD结果与预后显著相关。
