Objective To explore the relationship between minimal residual disease(MRD)on the 19th day(D19)and prognosis of children with acute B-lymphoblastic leukemia(B-ALL),as well as the correlation with related biological changes.Methods A total of 88 children with B-ALL newly diagnosed in this hospital from April 2016 to April 2020 who met the enrollment conditions were analyzed for induction therapy D19 MRD,overall survival(OS)rate,event-free survival(EFS)rate,chromosome karyotype,fusion gene and mu-tation gene.MRD≥ 0.01％was considered positive,and they were divided into MRD positive group and MRD negative group.The characteristics of OS rate,EFS rate,immunophenotype and molecular biology/cytogenet-ics were compared between the two groups over a period of 3 years.Results The 3-year OS rate and EFS rate of 88 pediatric patients were 92.0％and 86.4％,respectively.The rates of OS rate and EFS rate in MRD posi-tive group were lower than those in MRD negative group,with statistical significance(P＜0.05).The detec-tion rate of CD10 in MRD positive group was lower than that in MRD negative group,and the difference was statistically significant(P＜0.05).Thirty-two patients(36.4％)detected 8 types of 35 fusion genes.The de-tection rates of BCR-ABL1 and E2A-PBX1 in MRD positive group were higher than those in MRD negative group,and the differences were statistically significant(P＜0.05).Among 48 cases(54.5％)of pediatric pa-tients,41 types of 91 mutated genes were detected,and the remaining mutated genes were less than 5 cases.Abnormal karyotype was detected in 18 cases(20.5％),and no mitotic phase was detected in 17 cases.There was no difference in MRD between normal and abnormal karyotype.Binary Logistic regression analysis showed that BCR-ABL1 and E2A-PBX1 were prognostic factors of children with B-ALL.Conclusion The positive D19 MRD is the influential factor of adverse OS and EFS in children with B-ALL.Both E2A-PBX1 and BCR-ABL1 have adverse effects on the prognosis of children with B-ALL.

Objective To analyze the molecular biological characteristics of children with acute lymphoblastic leukemia(ALL)and explore its influence on prognosis.Methods Clinical data of 104 newly diagnosed children with ALL in the Affiliated Hospital of Xuzhou Medical University from January 2017 to February 2021 were collected to analyze the detection of fusion genes and mutated genes and their effects on clinical characteristics and prognosis.Results There were 64males and 40 females.The median age at first visit was 5 years(3months to 14 years);B-ALL 95 cases,T-ALL 9 cases;there were 13deaths and 16 relapses.Among the 104 children,40 cases(38.5％)were detected with 9 fusion genes,including TEL-AML1,BCR-ABL1,MLL rearrangement,E2A-PBX1,SIL-TAL1,etc.SIL-TAL1 was found in T-ALL,and the other 8 fusion genes were found in B-ALL.Of the 96 children who underwent mutated gene detection,65 cases(67.7％)detected 33mutated genes,the high mutation rate was KRAS,NRAS,FLT3,IKZF1,TP53 and PAX5,and the high mutation rate was KRAS and NRAS in B-ALL.The high mutation rates of T-ALL were NOTCH 1 and FBWX7.The age of first diagnosis was younger in the MLL rearrangement group and older in the BCR-ABL1 positive group.MLL rearrangement,BCR-ABL1,NOTCH 1 mutation,IKZF1mutation positive group was prone to hyperleukaemia at first diagnosis,and BCR-ABL1 and NOTCH1 mutation positive group had high lactate dehydrogenase(LDH).Abnormal karyotypes were more common in children with posi-tive BCR-ABL1 and IKZF1 mutations.The 3-year overall survival(OS)rate and event-free survival(EFS)rate were low in children with MLL rearrangement,the 3-year OS rate was low in children with BCR-ABL1 positive,and the 3-year EFS rate was low in the IKZF1 mutant group.The failure of TEL-AML1 to turn negative after consolidation therapy was associated with recurrence in children with this subtype(P＜0.05).Conclusion Different molecular biological abnormalities have different effects on the clinical characteristics and prognosis of children with ALL.

Objective To analyze the molecular biological characteristics of children with acute lymphoblastic leukemia(ALL)and explore its influence on prognosis.Methods Clinical data of 104 newly diagnosed children with ALL in the Affiliated Hospital of Xuzhou Medical University from January 2017 to February 2021 were collected to analyze the detection of fusion genes and mutated genes and their effects on clinical characteristics and prognosis.Results There were 64males and 40 females.The median age at first visit was 5 years(3months to 14 years);B-ALL 95 cases,T-ALL 9 cases;there were 13deaths and 16 relapses.Among the 104 children,40 cases(38.5％)were detected with 9 fusion genes,including TEL-AML1,BCR-ABL1,MLL rearrangement,E2A-PBX1,SIL-TAL1,etc.SIL-TAL1 was found in T-ALL,and the other 8 fusion genes were found in B-ALL.Of the 96 children who underwent mutated gene detection,65 cases(67.7％)detected 33mutated genes,the high mutation rate was KRAS,NRAS,FLT3,IKZF1,TP53 and PAX5,and the high mutation rate was KRAS and NRAS in B-ALL.The high mutation rates of T-ALL were NOTCH 1 and FBWX7.The age of first diagnosis was younger in the MLL rearrangement group and older in the BCR-ABL1 positive group.MLL rearrangement,BCR-ABL1,NOTCH 1 mutation,IKZF1mutation positive group was prone to hyperleukaemia at first diagnosis,and BCR-ABL1 and NOTCH1 mutation positive group had high lactate dehydrogenase(LDH).Abnormal karyotypes were more common in children with posi-tive BCR-ABL1 and IKZF1 mutations.The 3-year overall survival(OS)rate and event-free survival(EFS)rate were low in children with MLL rearrangement,the 3-year OS rate was low in children with BCR-ABL1 positive,and the 3-year EFS rate was low in the IKZF1 mutant group.The failure of TEL-AML1 to turn negative after consolidation therapy was associated with recurrence in children with this subtype(P＜0.05).Conclusion Different molecular biological abnormalities have different effects on the clinical characteristics and prognosis of children with ALL.