通过动态评估以 MRD 为基础的策略对 B-ALL 治疗决策的指导意义--回顾性研究中的生存差异给我们带来的启示。

IF 2 4区 医学 Q3 HEMATOLOGY
Hematology Pub Date : 2024-12-01 Epub Date: 2024-10-17 DOI:10.1080/16078454.2024.2415589
Yongyu Chen, Rongrong Liu, Jing Li
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引用次数: 0

摘要

目的:该研究旨在通过分析B细胞急性淋巴细胞白血病(B-ALL)患者的临床特征,了解相关因素对患者长期生存的影响,并观察动态可测量残留病(MRD)评估对B-ALL患者预后和治疗选择的意义,旨在加深对该疾病的认识,改善B-ALL患者的生存预后:方法:收集65例B-ALL患者的临床特征,计算中位总生存期(OS)和中位无病生存期(PFS),并评估动态MRD评估指导生存分析的意义:基于动态MRD评估的生存分析表明,在诱导化疗后的动态评估中保持MRD阴性状态的B-ALL患者在亚组之间的无进展生存期比较中具有更好的生存结果,差异有统计学意义(P = 0.0002 (HR: 0.26, 95% CI: 0.13-0.51))。在诱导化疗后的动态评估中保持MRD阴性状态的高危B-ALL患者的中位无进展生存期更长,亚组间的生存期差异有统计学意义(P = 0.0016 (HR: 0.28, 95% CI: 0.09-0.48)):动态MRD评估具有重要的临床价值:动态评估期间保持MRD阴性状态可改善B-ALL患者的预后和生存;诱导化疗后的动态MRD评估有助于指导后续治疗,为未来治疗策略的推进提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The significance of MRD-based strategy by dynamic assessment to guide treatment decisions in B-ALL - the enlightenment provided by demonstrating survival differences in the retrospective study.

Purpose: The study aimed to access the impact of related factors on the long-term survival of patients with B-cell acute lymphoblastic leukemia (B-ALL) by analyzing clinical characteristics of B-ALL patients, and observed the significance of dynamic measurable residual disease (MRD) assessment for the prognosis and treatment selection of B-ALL patients, aiming to deepen the understanding of the disease and improve the survival prognosis of B-ALL patients.

Methods: The clinical characteristics of 65 patients with B-ALL were collected to calculate the median overall survival (OS) and median disease-free survival (PFS), and to evaluate the significance of survival analysis guided by dynamic MRD assessment.

Results: The survival analysis based on dynamic MRD assessment suggested that B-ALL patients who maintained MRD negative status during dynamic assessment after induction chemotherapy had better survival outcomes in the comparison of progression-free survival between subgroups, with statistically significant differences (P = 0.0002 (HR: 0.26, 95% CI: 0.13-0.51)). High-risk B-ALL patients who maintained negative MRD status during dynamic assessment after induction chemotherapy had longer median progression - free survival, and the survival difference between subgroups was statistically significant (P = 0.0016 (HR: 0.28, 95% CI: 0.09-0.48)).

Conclusion: Dynamic MRD assessment had significant clinical value: maintaining negative MRD status during dynamic assessment can improve the prognosis and survival of B-ALL patients; dynamic MRD assessment after induction chemotherapy can help guide subsequent treatment, which could provide reference for the advancement of future treatment strategies.

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来源期刊
Hematology
Hematology 医学-血液学
CiteScore
2.60
自引率
5.30%
发文量
140
审稿时长
3 months
期刊介绍: Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.
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