Prognostic value of combined digital PCR and multiparametric flow cytometry monitoring MRD in non-transplant acute myeloid leukemia.

IF 0.6 4区医学 Q4 HEMATOLOGY

Journal of Hematopathology Pub Date : 2026-04-14 DOI:10.1007/s12308-026-00692-8

Shaojie Ye, Huimei Guo, Jianmei Xu, Xi Su, Lin Wang, Jiangbo Zhang, Jia Liu, Songying Zhao, Jing Wang, Hua Xue

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引用次数: 0

Abstract

Objective: To evaluate the synergistic prognostic value of digital PCR (dPCR)-based multigene measurable residual disease (MRD) monitoring combined with multiparametric flow cytometry (MFC) in patients with non-transplant acute myeloid leukemia (AML).

Methods: This observational cohort study analyzed 86 newly diagnosed AML patients (excluding APL) at the Affiliated Hospital of Hebei University (January 2018-May 2025). MRD was assessed using MFC (threshold: 0.1%) and dPCR (variant allele frequency [VAF] < 0.001%). Outcomes included relapse-free survival (RFS), overall survival (OS), and cumulative relapse rates.

Results: With a median follow-up time of 18.5 months, dPCR-MRD negativity predicted superior 2-year RFS (67.1% vs 42.3%, HR = 0.365, P = 0.003). Combined MFC/dPCR negativity further enhanced prognostic discrimination (2-year RFS: 68.2% vs 40.5%, HR = 0.323, P = 0.001). Subgroup analysis revealed MFC-driven RFS benefits in intensive chemotherapy (72.2% vs 33.3%, HR = 0.180, P = 0.014), while dual-platform monitoring showed trends favoring non-intensive regimens (58.7% vs 31.7%, HR = 0.407, P = 0.051).

Conclusion: dPCR-MRD monitoring complements MFC for the stratification of risk of relapse, particularly among non-transplant AML patients. Dual-platform integration improves predictive accuracy, supporting personalized MRD-guided strategies.

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数字PCR与多参数流式细胞术联合监测MRD在非移植急性髓系白血病中的预后价值。

目的：评价基于数字PCR （dPCR）的多基因可测量残留病（MRD）监测联合多参数流式细胞术（MFC）对非移植性急性髓系白血病（AML）患者预后的协同价值。方法：本观察性队列研究分析了河北大学附属医院（2018年1月- 2025年5月）86例新诊断的AML（不包括APL）患者。采用MFC（阈值：0.1%）和dPCR（变异等位基因频率[VAF]）评估MRD。结果：中位随访时间为18.5个月，dPCR-MRD阴性预测2年RFS较好（67.1% vs 42.3%, HR = 0.365, P = 0.003）。MFC/dPCR联合阴性进一步增强了预后歧视（2年RFS: 68.2% vs 40.5%, HR = 0.323, P = 0.001）。亚组分析显示，mfc驱动的RFS在强化化疗中获益（72.2% vs 33.3%, HR = 0.180, P = 0.014），而双平台监测显示，非强化化疗方案获益（58.7% vs 31.7%, HR = 0.407, P = 0.051）。结论：dPCR-MRD监测是MFC复发风险分层的补充，特别是在非移植性AML患者中。双平台集成提高了预测准确性，支持个性化mrd指导策略。

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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来源期刊

Journal of Hematopathology HEMATOLOGYPATHOLOGY-PATHOLOGY

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： The Journal of Hematopathology aims at providing pathologists with a special interest in hematopathology with all the information needed to perform modern pathology in evaluating lymphoid tissues and bone marrow. To this end the journal publishes reviews, editorials, comments, original papers, guidelines and protocols, papers on ancillary techniques, and occasional case reports in the fields of the pathology, molecular biology, and clinical features of diseases of the hematopoietic system. The journal is the unique reference point for all pathologists with an interest in hematopathology. Molecular biologists involved in the expanding field of molecular diagnostics and research on lymphomas and leukemia benefit from the journal, too. Furthermore, the journal is of major interest for hematologists dealing with patients suffering from lymphomas, leukemias, and other diseases. The journal is unique in its true international character. Especially in the field of hematopathology it is clear that there are huge geographical variations in incidence of diseases. This is not only locally relevant, but due to globalization, relevant for all those involved in the management of patients.