摘要
目的探讨微量残留病(MRD)监测在ETV6/RUNX1融合基因阴性、阳性急性B淋巴细胞白血病(B-ALL)患儿预后中的意义。方法收集2018年1月—2021年6月郑州大学附属儿童医院234例B-ALL患儿临床资料,其中ETV6/RUNX1融合基因阳性78例(阳性组)、阴性156例(阴性组)。比较阳性组和阴性组无复发生存期(RFS)差异;统计2个组诱导化疗第15天、第33天和巩固治疗开始前(第12周)MRD检测结果,分别记为MRD1、MRD2、MRD3;分析2个组组内MRD1、MRD2、MRD3在B-ALL患儿预后中的意义。结果与阴性组比较,阳性组RFS延长(P=0.029)。在阴性组内,MRD1阴性和阳性患儿RFS差异无统计学意义(P>0.05);MRD2、MRD3阴性患儿RFS均长于MRD2、MRD3阳性患儿(P<0.05);MRD3阳性是B-ALL患儿预后的独立影响因素(比值比值为=3.678,95%可信区间为1.254~10.785,P=0.018)。在阳性组内。MRD1、MRD2阴性和阳性患儿RFS差异无统计学意义(P>0.05);MRD3阴性患儿RFS长于MRD3阳性患儿;多因素分析结果显示,MRD3阳性并非患儿RFS的独立影响因素(P>0.05)。结论监测MRD对ETV6/RUNX1融合基因阴性B-ALL患儿预后的意义更大,建议持续监测;对于ETV6/RUNX1融合基因阳性患儿,MRD监测意义较弱,临床可根据实际情况决定是否采用。
Objective To analyze the significance of minimal residual disease(MRD)dynamic monitoring in the prognosis of acute B-lymphoblastic leukemia(B-ALL)children with positive and negative ETV6/RUNX1 fusion genes.Methods The clinical data of 234 children with B-ALL in the Children's Hospital of Zhengzhou University from January 2018 to June 2021 were collected.There were 78 children with ETV6/RUNX1 fusion gene(positive group)and 156 children without ETV6/RUNX1 fusion gene(negative group).The differences in relapse-free survival(RFS)between positive and negative groups were compared.The results of MRD in the 2 groups on the 15th day(MRD1)and the 33rd day(MRD2)of induction chemotherapy and before the start of consolidation therapy(the 12th week,MRD3)were calculated,and the significance of MRD1,MRD2 and MRD3 in the prognosis of B-ALL children was analyzed.Results Compared with negative group,the RFS in positive group were prolonged(P=0.029).In negative group,there was no statistical significance in RFS between MRD1 negative and positive children(P>0.05),but the RFS of MRD2 and MRD3 negative children were longer than those of MRD2 and MRD3 positive children(P<0.05),and MRD3 was an independent risk factor for RFS odds ratio was 3.678,95%confidence interval 1.254-10.785,P=0.018).In positive group,there was no statistical significance in RFS between MRD1 and MRD2 positive and negative children(P>0.05),but the RFS of MRD3 negative children was longer than those of MRD3 positive children,but MRD3 was not an independent risk factor for RFS(P>0.05).Conclusions MRD dynamic monitoring has prognostic significance for B-ALL children with negative ETV6/RUNX1 fusion gene,and MRD dynamic monitoring should be carried out.For positive ETV6/RUNX1 fusion gene children,the significance of MRD dynamic monitoring is weak.Clinic can decide whether to use according to actual situation.
作者
刘俊闪
郭明发
孙佳
史利欢
刘炜
段勇涛
LIU Junshan;GUO Mingfa;SUN Jia;SHI Lihuan;LIU Wei;DUAN Yongtao(Henan Key Laboratory of Pediatric Hematology,the Children's Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China;Department of Hematology and Oncology,the Children's Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)
出处
《检验医学》
CAS
2023年第3期209-214,共6页
Laboratory Medicine
基金
国家自然科学基金青年基金(22007086)。
