Comparative Analysis of Flow Cytometry and RQ-PCR for the Detection of Minimal Residual Disease in Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia after Hematopoietic Stem Cell Transplantation.
Comparative Analysis of Flow Cytometry and RQ-PCR for the Detection of Minimal Residual Disease in Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia after Hematopoietic Stem Cell Transplantation.
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DOI：
10.1016/j.bbmt.2018.03.015
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发表时间：
2018-09
期刊：
影响因子：
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通讯作者：
Xiangyu Zhao;Xiaosu Zhao;Huan Chen;Yazhen Qin;Lanping Xu;Xiao-hui Zhang;Kai-yan Liu;Xiao-jun Huang;Yingjun Chang
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文献类型：
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作者：
Xiangyu Zhao;Xiaosu Zhao;Huan Chen;Yazhen Qin;Lanping Xu;Xiao-hui Zhang;Kai-yan Liu;Xiao-jun Huang;Yingjun Chang
本研究旨在探讨造血干细胞移植后早期采用多参数流式细胞术（MFC）和实时定量PCR （RQ-PCR）检测微小残留病（MRD）在预测费城染色体阳性急性淋巴细胞白血病（Ph+-ALL）复发和无白血病生存（LFS）中的价值。在1个月和3个月保持完全分子缓解（BCR-ABL < 0.01%）状态的患者复发率较低（P= 0.01%）。2和<.001)和较好的LFS (P=。014和。013)比那些没有完全分子缓解的人。在1、2和3个月时MFC阴性与较低的复发率相关(P=。01。004，和。4)和更好的LFS (P=。044, < 0.0001，和。013年,分别)。多因素分析显示，MFC或RQ-PCR 3个月时MRD阳性是复发的独立危险因素(危险比[HR]， 6.042(95%可信区间[CI]， 2.283 ~ 15.988)，P<。LFS （HR, 3.614 （95% CI, 1.610 ~ 8.111),P = 0.002）和总生存率（HR, 2.547, 95% CI, 1.008 ~ 6.443），P = 0.048）。综上所述，MFC检测MRD与早期检测BCR-ABL的RQ-PCR是预测Ph+-ALL患者预后的重要指标，两者在预测预后方面具有互补作用。
The aim of this study was to examine the value of minimal residual disease (MRD) detection by multiparameter flow cytometry (MFC) and real-time quantitative PCR (RQ-PCR) at the early stage after hematopoietic stem cell transplantation for predicting relapse and leukemia-free survival (LFS) in Philadelphia chromosome–positive acute lymphoblastic leukemia (Ph+-ALL). Patients who maintained complete molecular remission (BCR-ABL <.01%) status at 1 and 3 months were associated with a lower relapse rate (P= .02 and <.001) and better LFS (P= .014 and .013) than were those without a complete molecular remission. Negative MFC at 1, 2, and 3 months was associated with a lower relapse rate (P= .01, .004, and .04, respectively) and better LFS (P= .044, <.0001, and .013, respectively). Multivariate analysis showed that MRD positivity identified by MFC or RQ-PCR at 3 months was an independent risk factor for relapse (hazard ratio [HR], 6.042 (95% confidence interval [CI], 2.283 to 15.988),P< .001), LFS (HR, 3.614 (95% CI, 1.610 to 8.111),P =.002), and overall survival (HR, 2.547, 95% CI, 1.008 to 6.443),P =.048). In summary, MRD detection by MFC and RQ-PCR detection of BCR-ABL at the early stage were important predictors of outcome in patients with Ph+-ALL, and these tests played complementary roles in predicting prognosis.