急性早幼粒细胞白血病的流式细胞术可测量残留病分析及与分子可测量残留病的相关性:一项真实世界的前瞻性研究。

Zhihao Wen, Xinran Xue, Shuhua Li, Yu Liu, Yongmei Jin, Nenggang Jiang, Hongyan Liao
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引用次数: 0

摘要

背景急性早幼粒细胞白血病(APL)是急性髓性白血病的一种亚型,其临床病程进展迅速且具有致命性。监测可测量/最小残留病(MRD)对急性髓性白血病的预后和临床治疗至关重要:研究残留白血病细胞的免疫表型,评估多参数流式细胞术(FCM)测量 MRD 的性能,并将其与分子监测在确诊 APL 患者中进行比较:设计:共招募了 277 名 APL 患者。通过 FCM 使用 1 管 10 色抗体面板对免疫表型进行前瞻性分析。通过实时定量聚合酶链反应(RQ-PCR)检测带有 PML::RARα的 APL 的 MRD。研究还考察了 MRD 作为生存指标的临床价值:根据 CD45 和侧散射散点图,APL 表现出 5 种不同的残留白血病细胞模式,所有细胞均为 CD9 阳性,且 CD117 先前未发现丢失。基于 FCM 的 MRD 评估显示,与 PCR 的吻合率为 87.7%。在巩固治疗结束时,PCR 和 FCM 测量的 MRD 可以区分总生存期(OS)较长和较短的患者(P = .04 和 P = .03)。与携带PML::RARα的APL患者相比,APL变异型患者的OS更短(P < .001):CD9是区分残留白血病细胞和正常分化髓系细胞的可靠标记物。FCM与PCR-MRD具有很高的可比性,在预测OS方面表现出色,因此有可能被用作APL患者临床治疗的常规指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Measurable Residual Disease Analysis by Flow Cytometry and Correlation With Molecular Measurable Residual Disease in Acute Promyelocytic Leukemia: A Real-World Prospective Study.

Context.—: Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia distinguished by its rapidly progressive and fatal clinical course. Measurable/minimal residual disease (MRD) monitoring is vital for the prognosis and clinical management of acute myeloid leukemia.

Objective.—: To examine the immunophenotypes of the residual leukemic cells, evaluate the performance of multiparametric flow cytometry (FCM) measuring MRD, and compare it with molecular monitoring in patients diagnosed with APL.

Design.—: Two hundred seventy-seven patients with APL were enrolled. Immunophenotypes were prospectively analyzed by a 1-tube-10-color antibody panel via FCM. MRD of APL with PML::RARα was detected by real-time quantitative polymerase chain reaction (RQ-PCR). The clinical value of MRD as an indicator of survival was also examined.

Results.—: APL showed 5 distinct patterns of residual leukemic cells, based on CD45 and side-scatter scattergram, all with CD9 positivity and a previously unrealized loss of CD117. FCM-based MRD evaluation showed a concordance rate of 87.7% with PCR. At the end of the consolidation therapy, MRD measured by both PCR and FCM could differentiate patients with longer and shorter overall survival (OS) (P = .04 and P = .03, respectively). Patients with APL variant had a shorter OS than patients with APL who harbored PML::RARα (P < .001).

Conclusions.—: CD9 is a reliable marker to differentiate residual leukemic cells from normally differentiating myeloid cells. FCM demonstrated a high comparability to PCR-MRD and an excellent performance in predicting OS, and thus could potentially be used as a routine indicator in the clinical management of patients with APL.

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