Objective: To investigate the prognostic significance of detection of minimal residual disease after first induction treatment (MRD₁) in adult acute lymphoblastic leukemia (ALL) patients treated with autologous stem cell transplantation (auto-HSCT). Methods: The clinical data of 87 ALL patients who underwent auto-HSCT during February 2006 to April 2017 with MRD₁ detection data by flow cytometry were analyzed retrospectively. The relationship between MRD₁ and relapse and survival of ALL patients after auto-HSCT was studied. Results: Of 87 patients, 26 (29.9%) were MRD₁ positive. The proportion of high-risk immunophenotype (pro-B, pro-T, pre-T, mature T) was significantly higher in MRD₁-positive patients than that in MRD₁ negative patients (34.6% vs 14.5%, P=0.038). There was no significant difference between positive and negative MRD₁ patients at age, sex, lineage (T/B), immunophenotype (standard risk/high risk), high white blood cell count (B-ALL>30×10⁹/L or T-ALL>100×10⁹/L), high-risk chromosome/gene ratio, the time from first complete remission to transplantation and pre-treatment regimen. The 5-year overall survival (OS) and leukemia-free survival (LFS) in MRD₁ negative and positive patients were 72.7% vs 47.3% (P=0.004) and 75.7% vs 29.6% (P<0.001), respectively. Multivariate analysis showed that positive MRD₁ was an independent risk factor for OS (HR=3.007, 95% CI 1.256-7.200, P=0.013) , and positive MRD₁ and high-risk immunophenotype were risk factors for LFS (HR=3.986, 95% CI 1.813-8.764, P=0.001; HR=2.981, 95% CI 1.373-6.473, P=0.006) . Conclusions Auto-HSCT could not reverse the poor prognosis of MRD₁ positive patients. Auto-HSCT treatment is optional for patients with MRD₁ negative and maintaining MRD₁ negative status during intensive therapy.

Objective To study the expression levels and its clinical significance of angiopoietin 2 (Ang-2) gene in acute lymphatic leukemia(ALL). Methods The qualitative detection method was established with SYBR Green Ⅰ by real-time fluorescent quantitative PCR, and Ang-2 mRNA was measured in 51 cases of pre-therapeutic ALL. In addition, the expression of Ang-2 gene was also analyzed in 20 cases of non-malignant hematological diseases. Results The expression of Ang-2 gene was found in all the patients, and Ang-2 expression level in ALL patients was significantly higher than that of the controls (P<0.05). No significant relationship was found between Ang-2 expression level and clinical characteristics (age, haematogloblin, WBC count, platelet count, LDH, blast cells in peripheral blood, blast cells in bone marrow). The expression level of Ang-2 have no effect on one year replase rate and survival rate in ALL. Conclusion Ang-2 expression level in ALL patients was higher than that in non-malignant hematological diseases, and there may be no relationship with clinical manifestation, treatment and prognosis.