Prognostic significance of molecular minimal residual disease before and after allogeneic hematopoietic stem cell transplantation in children with acute myeloid leukemia.
10.7499/j.issn.1008-8830.2410118
- Author:
Xiu-Wen XU
1
;
Hao XIONG
1
;
Jian-Xin LI
1
;
Zhi CHEN
1
;
Fang TAO
1
;
Yu DU
1
;
Zhuo WANG
1
;
Li YANG
;
Wen-Jie LU
;
Ming SUN
Author Information
1. Department of Hematology, Wuhan Children's Hospital/Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Publication Type:Journal Article
- Keywords:
Acute myeloid leukemia;
Child;
Hematopoietic stem cell transplantation;
Minimal residual disease;
prognosis
- MeSH:
Humans;
Hematopoietic Stem Cell Transplantation;
Neoplasm, Residual;
Leukemia, Myeloid, Acute/genetics*;
Child;
Male;
Female;
Child, Preschool;
Prognosis;
Adolescent;
Infant;
Transplantation, Homologous
- From:
Chinese Journal of Contemporary Pediatrics
2025;27(6):675-681
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the prognostic value of molecular minimal residual disease (Mol-MRD) monitored before and after allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric acute myeloid leukemia (AML).
METHODS:Clinical data of 71 pediatric AML patients who underwent HSCT between August 2016 and December 2023 were analyzed. Mol-MRD levels were dynamically monitored in MRD-positive patients, and survival outcomes were evaluated.
RESULTS:No significant difference in the 3-year overall survival (OS) rate was observed between patients with pre-HSCT Mol-MRD ≥0.01% and <0.01% (77.3% ± 8.9% vs 80.4% ± 7.9%, P=0.705). However, patients with pre-HSCT Mol-MRD <1.75% had a significantly higher 3-year OS rate than those with Mol-MRD ≥1.75% (86.6% ± 5.6% vs 44.4% ± 16.6%, P=0.020). The median Mol-MRD level in long-term survivors was significantly lower than in non-survivors [0.61% (range: 0.04%-51.58%)] vs 10.60% (range: 1.90%-19.75%), P=0.035]. Concurrent flow cytometry-based MRD positivity was significantly higher in non-survivors (80% vs 24%, P=0.039). There was no significant difference in the 3-year overall survival rate between patients with Mol-MRD ≥0.01% and those with <0.01% at 30 days post-HSCT (P=0.527). For children with Mol-MRD <0.22% at 30 days post-HSCT, the 3-year overall survival rate was 80.4% ± 5.9%, showing no significant difference compared to those with molecular negativity (87.0% ± 7.0%) (P=0.523).
CONCLUSIONS:Patients with pre-HSCT Mol-MRD <1.75% or post-HSCT Mol-MRD <0.22% may achieve long-term survival outcomes comparable to Mol-MRD-negative cases through HSCT and targeted interventions.
