中国当代儿科杂志2025，Vol.27Issue(6)：675-681,7.DOI:10.7499/j.issn.1008-8830.2410118
儿童急性髓系白血病造血干细胞移植前后分子学微小残留病的预后意义
Prognostic significance of molecular minimal residual disease before and after allogeneic hematopoietic stem cell transplantation in children with acute myeloid leukemia
摘要
Abstract
Objective To investigate the prognostic value of molecular minimal residual disease(Mol-MRD)monitored before and after allogeneic hematopoietic stem cell transplantation(HSCT)in pediatric acute myeloid leukemia(AML).Methods Clinical data of 71 pediatric AML patients who underwent HSCT between August 2016 and December 2023 were analyzed.Mol-MRD levels were dynamically monitored in MRD-positive patients,and survival outcomes were evaluated.Results No significant difference in the 3-year overall survival(OS)rate was observed between patients with pre-HSCT Mol-MRD≥0.01%and<0.01%(77.3%±8.9%vs 80.4%±7.9%,P=0.705).However,patients with pre-HSCT Mol-MRD<1.75%had a significantly higher 3-year OS rate than those with Mol-MRD≥1.75%(86.6%±5.6%vs 44.4%±16.6%,P=0.020).The median Mol-MRD level in long-term survivors was significantly lower than in non-survivors[0.61%(range:0.04%-51.58%)]vs 10.60%(range:1.90%-19.75%),P=0.035].Concurrent flow cytometry-based MRD positivity was significantly higher in non-survivors(80%vs 24%,P=0.039).There was no significant difference in the 3-year overall survival rate between patients with Mol-MRD≥0.01%and those with<0.01%at 30 days post-HSCT(P=0.527).For children with Mol-MRD<0.22%at 30 days post-HSCT,the 3-year overall survival rate was 80.4%±5.9%,showing no significant difference compared to those with molecular negativity(87.0%±7.0%)(P=0.523).Conclusions Patients with pre-HSCT Mol-MRD<1.75%or post-HSCT Mol-MRD<0.22%may achieve long-term survival outcomes comparable to Mol-MRD-negative cases through HSCT and targeted interventions.关键词
急性髓系白血病/造血干细胞移植/微小残留病/预后/儿童Key words
Acute myeloid leukemia/Hematopoietic stem cell transplantation/Minimal residual disease/prognosis/Child引用本文复制引用
许秀文,孙鸣,熊昊,李建新,陈智,陶芳,杜宇,王卓,杨李,卢文婕..儿童急性髓系白血病造血干细胞移植前后分子学微小残留病的预后意义[J].中国当代儿科杂志,2025,27(6):675-681,7.基金项目
武汉市卫生健康委-临床医学科研项目(WX21Z48、WX21D60、WZ20Y04). （WX21Z48、WX21D60、WZ20Y04）
