Affiliation:
1. Hematologic Diseases Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children’s Health, Beijing
2. Beijing Key Laboratory of Pediatric Hematology-Oncology; Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children’s Health, Beijing
Abstract
Abstract
In childhood acute lymphoblastic leukemia (ALL), minimal residual disease (MRD) risk stratification criteria specific to common genetic subtypes are unclear. Among 723 children with newly diagnosed ALL treated with the Chinese Children Leukemia Group trial CCLG-2008 protocol, at time point 1 (TP1, the end of induction) and TP2 (before consolidation for standard risk and intermediate risk group, or before the second HR-I' block for high risk group), the MRD levels of children carrying different fusion genes or with T-ALL were significantly different (P all <0.001), and the prognostic significance of the same MRD level in the above subtypes was greatly different. For patients carrying BCR::ABL1 or KMT2A rearrangements, or ETV6::RUNX1, or with T-ALL, we defined those with both TP1 and TP2 MRD levels <10-2, TP1 MRD <10-3 and TP2 MRD-negative, TP1 MRD <10-3, as low MRD group respectively; the remaining children as high MRD group of each subtype. The 10-year relapse free survival (RFS) of low MRD group was significantly better than that of high MRD group. We verified the clinical value of the above MRD stratification criteria in patients treated with “Beijing Children’s Hospital BCH-ALL2003” protocol. In conclusion, subtype-specific MRD risk stratification may contribute to the precise treatment of childhood ALL.
Publisher
Research Square Platform LLC