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在儿科B细胞前急性淋巴细胞白血病中诱导后最小残留疾病:迈向精准医学的一步?

Ibrahim Ghemlas¹, Ibrahim Al-Ebaid¹, Khawar Siddiqui¹

¹Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Journal of hematology

|May 8, 2025

概括

诱导治疗后的最小残留疾病 (MRD) 是小儿急性淋巴细胞白血病 (ALL) 存活的关键预测因素. 早期检测MRD显著影响患者的结果,并指导治疗决策.

科学领域:

儿科瘤学儿科瘤学
血液学血液学血液学
癌症研究癌症研究

背景情况:

急性淋巴细胞白血病 (ALL) 是全球和沙特阿拉伯最常见的儿科癌症.
最小残留疾病 (MRD) 是ALL复发风险和长期结果的关键预后指标.
对于在ALL患者中量身定制风险适应疗法,MRD监测至关重要.

研究的目的:

调查MRD对儿科ALL患者生存结果的影响.
评估诱导后和巩固后MRD在预测患者预后方面的作用.
确定影响儿科ALL生存的显著风险因素.

主要方法:

对108名儿科ALL患者 (年龄≤14岁) 的医疗记录的回顾性审查.
患者在2016年1月至2018年12月期间接受治疗.
结果的评估是基于诱导后和巩固后阶段的MRD状态.

主要成果:

总生存率 (OS) 为89.2±3.1%,在诱导后的MRD阳性病例 (74.2±8.6%) 和MRD阴性病例 (94.7±2.6%) 中的OS显著较低.
在诱导后的MRD阳性病例 (61.1±10.2%) 和MRD阴性病例 (92.1±3.1%) 中,无事件生存 (EFS) 也明显较差.
在所有评估的风险因素中,诱导后MRD阳性是唯一与OS显著相关的因素.

结论:

诱导后MRD是影响儿科ALL患者结果的关键因素.
诱导后MRD阳性患者在巩固治疗后表现出改善的结果.
诱导后MRD与其他传统风险因素 (如年龄,性别或细胞遗传学) 之间没有发现显著的关联.

关键词:

急性淋巴细胞白血病 (Acute Lymphoblastic Leukemia) 是一种急性淋巴细胞白血病.骨髓骨髓骨髓骨髓骨髓最低残留疾病的最低残留疾病儿科儿科儿科风险因素风险因素干细胞移植干细胞移植幸存的生存方式

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