Minimal Residual Disease in Acute Lymphoblastic Leukaemia and Its Relationship with Other Prognostic Factors.

Chinmayee Agrawal, Sai Madhuri Boppana, Santhosh K Devdas, Vinayak V Maka, Nalini Kilara, Swaratika Majumdar, Rasmi Palassery
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Abstract

Background: Minimal Residual Disease (MRD) assessment is crucial for directing treatment decisions in Acute Lymphoblastic Leukemia (ALL). In low- and middle-income countries, limited resources can present challenges to implementing MRD-guided therapy intensification for ALL. The study attempted to assess the relationship between MRD and other prognostic factors in ALL, focusing on treatment outcomes and disease progression. Materials and Methods: A retrospective observational study was conducted at Ramaiah Medical College and Hospital in Bengaluru, examining patient data from January 2021 to December 2021. MRD status was determined post-induction using flow cytometry. Patients were classified into various groups based on factors such as type of ALL (B-cell or T-cell), NCI risk status (standard or high), cytogenetic risk (favorable, poor, or intermediate), CNS status, prednisone response, and MRD levels at the end of induction. Results: Out of 72 patients, 25% were MRD-positive, with a male: female ratio of 2.13:1. B-ALL was diagnosed in 49 patients and T-ALL in 23, with 75% categorized as high-risk by NCI criteria. Cytogenetic analysis revealed a diverse profile (23.61% PR, 48.61% IR, 27.78% FR), and 58.33% exhibited a good prednisone response (GPR). At the end of the induction phase, 25% tested positive for MRD, with B-ALL showing a lower MRD rate at 15.2%. Age and NCI risk status significantly influenced MRD outcomes, with 75% of participants classified as high-risk. Conclusion: This study demonstrates a significant association between MRD positivity and factors such as age, NCI risk status, and B-ALL diagnosis, underscoring the complex interaction of these variables in predicting treatment outcomes for ALL patients.

急性淋巴细胞白血病微小残留病及其与其他预后因素的关系。
背景:极小残留病(MRD)评估对于指导急性淋巴细胞白血病(ALL)的治疗决策至关重要。在低收入和中等收入国家,有限的资源可能对实施耐药指导的ALL强化治疗带来挑战。该研究试图评估ALL中MRD与其他预后因素之间的关系,重点关注治疗结果和疾病进展。材料和方法:在班加罗尔的Ramaiah医学院和医院进行了一项回顾性观察研究,检查了2021年1月至2021年12月的患者数据。诱导后用流式细胞术检测MRD状态。根据ALL类型(b细胞或t细胞)、NCI风险状态(标准或高)、细胞遗传学风险(有利、差或中等)、中枢神经系统状态、泼尼松反应和诱导结束时的MRD水平等因素将患者分为不同的组。结果:72例患者中mrd阳性25%,男女比例为2.13:1。49例诊断为B-ALL, 23例诊断为T-ALL,其中75%根据NCI标准被归类为高风险。细胞遗传学分析显示不同的谱(23.61% PR, 48.61% IR, 27.78% FR), 58.33%表现出良好的泼尼松反应(GPR)。在诱导期结束时,25%的患者MRD检测呈阳性,B-ALL的MRD率较低,为15.2%。年龄和NCI风险状态显著影响MRD结果,75%的参与者被归类为高风险。结论:本研究表明MRD阳性与年龄、NCI风险状态和B-ALL诊断等因素之间存在显著关联,强调了这些变量在预测ALL患者治疗结果方面的复杂相互作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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