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2025年关于急性髓性白血病中MRD的更新:来自ELN-DAVIDMRD工作组的共识文件

Jacqueline Cloos¹, Peter J M Valk², Christian Thiede³

¹Amsterdam University Medical Center, location VUMC, Cancer Center Amsterdam, Amsterdam, Netherlands.

|December 15, 2025

概括

更新的指南加强了急性髓性白血病 (AML) 中可测量的残留疾病 (MRD) 监测. 新的类别和超高灵敏度测试改善了AML患者的风险评估和治疗指南.

科学领域:

血液学血液学血液学
在瘤学瘤学.
临床指南临床指南

背景情况:

可测量的残留疾病 (MRD) 监测对于急性髓性白血病 (AML) 预后,治疗指导和临床试验终点至关重要.
现有的MRD评估框架需要改进,以与当前的AML分类和临床实践保持一致.

研究的目的:

介绍欧洲白血病网 (ELN) 针对白血病管理的MRD指南的2025年更新.
为MRD评估提供协调的框架,结合专家的共识和针对不同患者子组的定制建议.

主要方法:

由ELN-DAVID财团使用两阶段的Delphi过程制定指南.
在临床实施,技术方面的专家共识的纳入,并整合到临床试验.
制定了56条建议,其中53条达到了高度共识 (≥90%).

主要成果:

引入一个新的定性MRD响应类别 (最佳,警告,高风险) 用于上下文解释.
基于下一代测序 (NGS) 的超高灵敏度 (UHS) 的MRD评估对FLT3-ITD突变的AML的建议.
这些指导方针与ELN 2022遗传风险分类保持一致,并根据预后亚组量身定制.

结论:

更新的MRD指南为AML管理提供了精细的框架,提高了预后准确性和治疗决策.
在不同治疗环境中对MRD评估的协调是先进的,提高了临床效用.
这些指导方针代表了通过标准化MRD监测优化患者护理和AML的结果的重要一步.

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