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Prognostic and therapeutic implications of measurable residual disease levels during remission induction of childhood ALL

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收录情况： ◇ SCIE

作者：
Zhang Weina[1] * ; Cai Jiaoyang[2] ; Wang Xiang[3] ; Ma Yani[3] ; Zhu Xiaofan[4] ; Yu Jie[5] ; Xiao Peifang[6] ; Gao Ju[7] ; Fang Yongjun[8] ; Liang Changda[9] ; Li Xue[10] ; Zhou Fen[11] ; Zhai Xiaowen[12] ; Xu Xiaoxiao[13] ; Tian Xin[14] ; Liu Aiguo[15] ; Wang Ningling[16] ; Zhu Jiashi[17] ; Wang Lingzhen[18] ; Cheng Frankie Wai Tsoi[19] ; Yang Liangchun[20] ; Zhang Ge[21] ; Cheng Cheng[22] ; Yang Jun J[22] ; Shen Shuhong[2] ; Li Chi-Kong[23] ; Li Benshang[24] ; Jiang Hua[25] ; Pui Ching-Hon[22] ;
机构： [1]Guangzhou Medical University Affiliated Women and Children's Medical Center, Guangzhou, China. [2]Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. [3]Shanghai Children's Medical Center, Shanghai, China. [4]Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China. [5]Children's Hospital of Chongqing Medical University. [6]Children's Hospital of Soochow University. [7]Sichuan University, Chengdu, China. [8]Children's Hospital of Nanjing Medical University, Nanjing, China. [9]Jiangxi Provincial Children's Hospital, Nanchang, China. [10]Qilu Hospital of Shandong University, Shan Dong Sheng, China. [11]Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [12]Children's hospital of Fudan university, Shanghai, Alabama, China. [13]Nanfang Hospital, Southern Medical University, Guangzhou, China. [14]KunMing Children's Hospital, Kunming, China. [15]Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [16]Second Hospital of Anhui Medical University, Hefei, China. [17]Shanghai Children's Hospital, Shanghai, China. [18]Affiliated Hospital of Qingdao University, Qingdao, China. [19]Hong Kong Children's Hospital, Hong Kong, Hong Kong. [20]Xiangya hospital, Central South University, Changsha, China. [21]Xi'an Northwest Women's and Children's Hospital, Xi'an, Shaanxi Province, China. [22]St. Jude Children's Research Hospital, Memphis, Tennessee, United States. [23]The Chinese University of Hong Kong, Hong Kong, Hong Kong. [24]Key Laboratory of Pediatric Hematology and Oncology Ministry of Health, Shanghai, China. [25]Department of Hematology, Guangzhou Medical University affliated Women and Children's Medical Center, Guangzhou, China
出处：
DOI： 10.1182/blood.2024026381
ISSN：

摘要：
We evaluated the prognostic and therapeutic significance of measurable residual disease (MRD) during remission induction in pediatric acute lymphoblastic leukemia (ALL) patients. In the CCCG-ALL-2015 protocol, 7640 patients were categorized into low-, intermediate-, or high-risk groups based on clinical and genetic features. Final risk classification was determined by MRD assessed via flow cytometry on Days 19 and 46 of remission induction, with additional intensified chemotherapy for Day 19 MRD ≥1%. B-ALL patients with negative MRD (<0.01%) on Day 19 or Day 46 had significantly better 5-year event-free survival (EFS) than those with MRD 0.01-0.99%, who in turn had better EFS than patients with MRD ≥1%. Provisional low-risk patients with Day 19 MRD ≥1% but negative Day 46 MRD, reclassified as intermediate-risk, had comparable 5-year EFS to low-risk patients with Day 19 MRD 0.3-0.99% and negative Day 46 MRD (82.5% vs. 83.0%) and better EFS than provisional low-risk patients with MRD on both days (83.0% vs. 72.6%, P<0.001). Similarly, provisional intermediate-risk B-ALL patients with Day 19 MRD ≥1% but negative Day 46 MRD, who received additional therapy, had better 5-year EFS compared to those with Day 19 MRD between 0.3-0.99% (70.7% vs. 53.0%, P<0.001). Among low-risk patients with negative Day 46 MRD, those with negative Day 19 MRD had superior EFS compared to those with positive Day 19 MRD (91.7% vs. 86.1%, P<0.001). Optimal use of Day 19 MRD could improve individualized treatment and outcomes. Chinese Clinical Trial Registry (ChiCTR-IPR-14005706).Copyright © 2024 American Society of Hematology.

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出版当年[2025]版：
大类 | 1 区 医学
小类 | 1 区 血液学
最新[2025]版：
大类 | 1 区 医学
小类 | 1 区 血液学
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出版当年[2025]版：
无
最新[2023]版：
Q1 HEMATOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2024版] 出版当年五年平均 出版前一年[2024版]

第一作者：
第一作者机构： [1]Guangzhou Medical University Affiliated Women and Children's Medical Center, Guangzhou, China.
推荐引用方式(GB/T 7714)：
Zhang Weina,Cai Jiaoyang,Wang Xiang,et al.Prognostic and therapeutic implications of measurable residual disease levels during remission induction of childhood ALL[J].Blood.2025,145(17):1890-1902.doi:10.1182/blood.2024026381.
APA：
Zhang Weina,Cai Jiaoyang,Wang Xiang,Ma Yani,Zhu Xiaofan...&Pui Ching-Hon.(2025).Prognostic and therapeutic implications of measurable residual disease levels during remission induction of childhood ALL.Blood,145,(17)
MLA：
Zhang Weina,et al."Prognostic and therapeutic implications of measurable residual disease levels during remission induction of childhood ALL".Blood 145..17(2025):1890-1902

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