The Quantification of Minimal Residual Disease Pre- and Post-Unmanipulated Haploidentical Allograft by Multiparameter Flow Cytometry in Pediatric Acute Lymphoblastic LeukemiaKey terms
The Quantification of Minimal Residual Disease Pre- and Post-Unmanipulated Haploidentical Allograft by Multiparameter Flow Cytometry in Pediatric Acute Lymphoblastic LeukemiaKey terms
复制标题
通过多参数流式细胞术对小儿急性淋巴细胞白血病中未操作单倍体同种异体移植前后的微小残留病进行定量关键术语
DOI：
10.1002/cyto.b.21840
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发表时间：
2019-08-19
影响因子：
3.4
通讯作者：
Chang, Ying-Jun
中科院分区：
文献类型：
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作者：
Wang, Xin-Yu;Fan, Qiao-Zhen;Chang, Ying-Jun
背景本研究旨在确定接受单倍体相合同种异体移植的儿童ALL患者的术前和术后微小残留病（MRD）状态以及围移植期MRD动力学对临床结局的影响。方法对166例患者进行回顾性研究。采用多参数流式细胞术测定MRD。结果MRD-neg患儿的累积复发率（CIR）低于MRD-pos患儿（19.7%vs.41.2%，P = 0.009）。与MRDneg后组相比，MRDpos后患者的CIR更高（81.0% vs. 15.9%，P < 0.001）、LFS较差（14.3% vs. 66.9%，P < 0.001）和OS（19.1% vs. 66.9%，P < 0.001）。在围MRD期动力学方面，与MRD降低组和MRDneg/MRDneg组相比，MRD升高组的CIR更高，LFS和OS的概率更低（P < 0.001）。与pre-MRDneg/post-MRDneg组相比，pre-MRDpos/post-MRDpos组（66.7% vs. 12.5%，P < 0.001）、pre-MRDpos/post-MRDneg组（32.0% vs. 12.5%，P = 0.016）和pre-MRDneg/post-MRDpos组（91.7% vs. 12.5%，P < 0.001）的CIR更高。术前MRDpos/术后MRDpos组和术前MRDneg/术后MRDpos组的LFS和OS发生率均低于术前MRDneg/术后MRDneg组（P < 0.05）。多变量分析证实了MRD前状态、MRD后状态和围MRD期动力学与结局的相关性（P < 0.05）。结论：结果表明，在儿童ALL亚组中，不仅术前MRD状态或术后MRD状态，而且SCT围术期MRD动态与单倍体相合同种异体移植后CIR增加相关。根据MRD动力学与单次MRD状态将患者分为不同的风险组。(c)2019国际临床细胞计数学会
Background This study aimed to determine the impact of the pre- and post-minimal residual disease (MRD) status as well as the peri-transplant MRD kinetics on clinical outcomes in pediatric ALL patients who received haploidentical allografts. Methods A retrospective study (n = 166) was performed. MRD was determined using multiparameter flow cytometry. Results Pediatric ALL patients with pre-MRDneg had a lower cumulative incidences of relapse (CIR) compared to those with pre-MRDpos (19.7% vs. 41.2%, P = 0.009). Compared to post-MRDneg group, patients with post-MRDpos experienced higher CIR (81.0% vs. 15.9%, P < 0.001), inferior LFS (14.3% vs. 66.9%, P < 0.001) and OS (19.1% vs. 66.9%, P < 0.001). In regard to peri-MRD kinetics, compared with the MRD-decreasing group and MRDneg/MRDneg group, MRD-increasing group had higher CIR, lower probabilities of LFS and OS (P < 0.001). Compared to pre-MRDneg/post-MRDneg group, a higher CIR was found in the pre-MRDpos/post-MRDpos group (66.7% vs. 12.5%, P < 0.001), pre-MRDpos/post-MRDneg group (32.0% vs. 12.5%, P = 0.016), and pre-MRDneg/post-MRDpos group (91.7% vs. 12.5%, P < 0.001). A lower incidence of LFS and OS were found in pre-MRDpos/post-MRDpos group and pre-MRDneg/post-MRDpos group than in pre-MRDneg/post-MRDneg group (P < 0.05). Multivariate analyses confirmed the association of pre-MRD status, post-MRD status, and peri-MRD kinetics with outcomes (P < 0.05). Conclusions The results indicate that, in the pediatric ALL subgroup, not only pre-MRD status or post-MRD status but also peri-SCT MRD dynamics, were associated with an increased CIR after haploidentical allografts. Patients are put into different risk group based on MRD kinetics versus single time MRD status. (c) 2019 International Clinical Cytometry Society