[The Correlation of Minimal Residual Disease with Prognosis in TCF3-PBX1+ Acute Lymphoblastic Leukemia in Children]
Li Zhang1, Yao Zou1, Xiao-Fei Ai1
1State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
Objective:
To investigate the consistency between FCM and PCR on the detecting of MRD in TCF3-PBX1+ ALL, and to investigate the prognosis value of these 2 methods.
Methods:
55 cases of paediatric TCF3-PBX1+ ALL patients from April 2008 to April 2015 were enrolled and analyzed. The FCM and PCR was used to detect the MRD in 239 bone marrow samples of 55 patients. All statistical analyses were carried out by using SPSS software version 16.
Results:
Among the 55 children with TCF3-PBX1+ ALL, there were 30 male and 25 female. The median age was 5 (1-14) years. 20 patients relapsed during follow-up. The MRD results from PCR and FCM showed a strong correlation between both methods (K=0.774, P<0.001). There was no significant difference in 5-years DFS and OS between the patients in PCR+ and PCR- groups on day 15 or day 33. The 5 year DFS rate between the patients in FCM- and FCM+ was 63.9%±7.0% and 0; the 5 year OS rate was 66.5%±7.9% and 0. Combined with the result of FCM and PCR, at the d 33 of treatment, the 5-year DFS rate in FCM-/PCR- and single positive group was 65.4%±7.2% and 25.0%±15.3% (P<0.01).
Conclusion:
The detection result of MRD in TCF3-PBX1 detect by FCM and PCR shows better consistency. MRD positivity detected by FCM at the end of induction therapy (day 33) predicts a high risk of relapse in TCF3-PBX1 ALL patients.
Insights
Flow cytometry (FCM) and polymerase chain reaction (PCR) show consistent results for detecting minimal residual disease (MRD) in TCF3-PBX1+ acute lymphoblastic leukemia (ALL). FCM positivity at day 33 predicts a high relapse risk in pediatric ALL patients.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Minimal residual disease (MRD) detection is crucial for TCF3-PBX1+ acute lymphoblastic leukemia (ALL) prognosis.
- Investigating the consistency and prognostic value of flow cytometry (FCM) and polymerase chain reaction (PCR) for MRD detection is essential.
Purpose of the Study:
- To evaluate the concordance between FCM and PCR in detecting MRD in pediatric TCF3-PBX1+ ALL.
- To assess the prognostic significance of FCM and PCR-based MRD detection.
Main Methods:
- Analysis of 55 pediatric TCF3-PBX1+ ALL cases (April 2008-April 2015).
- Detection of MRD using FCM and PCR in 239 bone marrow samples.
- Statistical analysis using SPSS software.
Main Results:
- Strong correlation observed between FCM and PCR for MRD detection (K=0.774, P<0.001).
- No significant difference in 5-year disease-free survival (DFS) and overall survival (OS) based on PCR results.
- FCM positivity at day 33 strongly predicted relapse, with 0% 5-year DFS and OS compared to 63.9% DFS and 66.5% OS in FCM-negative patients.
- Combined FCM/PCR negativity at day 33 was associated with better outcomes (65.4% 5-year DFS) than single positive results (25.0% 5-year DFS).
Conclusions:
- FCM and PCR demonstrate good consistency in detecting MRD in TCF3-PBX1+ ALL.
- MRD positivity by FCM at day 33 of induction therapy is a significant predictor of relapse in TCF3-PBX1+ ALL.
