Persistent MRD before and after allogeneic BMT predicts relapse in children with acute lymphoblastic leukaemia
Persistent MRD before and after allogeneic BMT predicts relapse in children with acute lymphoblastic leukaemia
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DOI：
10.1111/bjh.13142
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发表时间：
2015-02-01
影响因子：
6.5
通讯作者：
O'Brien, Tracey A.
中科院分区：
文献类型：
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作者：
Sutton, Rosemary;Shaw, Peter J.;O'Brien, Tracey A.
早期化疗期间的微小残留病（MRD）是急性淋巴细胞白血病（ALL）复发的有力预测因素，并用于儿童确定首次（CR 1）或以后完全缓解（CR 2/CR 3）时接受异基因造血干细胞移植（HSCT）的资格。在ANZCHOG ALL 8试验的81名儿童中分析了影响HSCT结局的变量。治疗失败的主要原因是复发，5年累积复发率（CIR）为32%，治疗相关死亡率为8%。在CR 1（LFS 62%，OS 83%，n=41）或CR2/CR 3（LFS 60%，OS 72%，n=40）中，HSCT的无白血病生存期（LFS）和总生存期（OS）相似。HSCT前骨髓MRD阴性患者的预后（LFS 83%，OS 92%）优于HSCT前MRD持续者（LFS 41%，OS 64%，P
Minimal residual disease (MRD) during early chemotherapy is a powerful predictor of relapse in acute lymphoblastic leukaemia (ALL) and is used in children to determine eligibility for allogeneic haematopoietic stem cell transplantation (HSCT) in first (CR1) or later complete remission (CR2/CR3). Variables affecting HSCT outcome were analysed in 81 children from the ANZCHOG ALL8 trial. The major cause of treatment failure was relapse, with a cumulative incidence of relapse at 5years (CIR) of 32% and treatment-related mortality of 8%. Leukaemia-free survival (LFS) and overall survival (OS) were similar for HSCT in CR1 (LFS 62%, OS 83%, n=41) or CR2/CR3 (LFS 60%, OS 72%, n=40). Patients achieving bone marrow MRD negativity pre-HSCT had better outcomes (LFS 83%, OS 92%) than those with persistent MRD pre-HSCT (LFS 41%, OS 64%, P