移植前微小残留病检测在急性T淋巴细胞白血病患者异基因造血干细胞移植治疗中的意义

王晴晴; 千晨静; 杨菲燕; 夏凌辉

doi:10.13201/j.issn.1004-2806.2021.07.004

移植前微小残留病检测在急性T淋巴细胞白血病患者异基因造血干细胞移植治疗中的意义

- 华中科技大学同济医学院附属协和医院血液科(武汉, 430022)
基金项目:
国家自然科学基金资助项目(No:81974003)

详细信息

通讯作者: 夏凌辉,E-mail:linghuixia@hust.edu.cn

中图分类号: R733.71

收稿日期: 2020-11-16

Significance of preoperative minimal residual disease detection in allogeneic hematopoietic stem cell transplantation in patients with acute T-lymphoblastic leukemia

- Department of Hematology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technolog, Wuhan, 430022, Chinay

More Information

Corresponding author: XIA Linghui, E-mail: linghuixia@hust.edu.cn

Received Date: 16 November 2020

摘要

摘要: 目的:探讨移植前微小残留病(MRD)检测在急性T淋巴细胞白血病(T-ALL)患者行异基因造血干细胞移植治疗中临床意义。方法:选取并分析2013年1月—2019年8月在武汉协和医院层流病房行异基因造血干细胞移植的67例T-ALL患者的病例资料。其中移植前达形态学完全缓解(CR)的患者65例,未完全缓解者(NCR)2例,按照移植前MRD是否转阴将CR组分为MRD⁺组(13例)和MRD^-组(52例)。对比分析CR组与NCR组,MRD⁺组与MRD^-组移植预后的差异,探讨移植前MRD是否转阴与患者移植预后的相关性。结果:CR组与NCR组患者移植后3年总生存率(72.4%vs 0)、无病生存率(67.1%vs 0)、累积复发率(36.1%vs 100%)比较,差异均有统计学意义(P<0.001)。CR组中移植前MRD⁺患者与MRD^-患者移植后3年总生存率(41.5%vs 52.9%)、无病生存率(41.5%vs 55.8%)、累积复发率(67.6%vs 33.6%)比较,差异均有统计学意义(P<0.05)。结论:移植前检测MRD是否转阴可作为T-ALL患者异基因造血干细胞移植治疗中判断预后的重要因素。
- 急性T淋巴细胞白血病 /
- 异基因造血干细胞移植 /
- 微小残留病
Abstract: Objective: To investigate the clinical significance of minimal residual disease(MRD) detection before transplantation in allogeneic hematopoietic stem cell transplantation in patients with acute T-lymphoblastic leukemia(T-ALL).Methods: The data of 67 T-ALL patients who underwent allogeneic hematopoietic stem cell transplantation in laminar flow ward of Wuhan Union Hospital from January 2013 to August 2019 were selected and analyzed. There were 65 patients with morphological complete remission(CR) and 2 patients with incomplete remission(NCR) before transplantation. According to whether MRD turned negative before transplantation, 65 patients in CR group was divided into MRD⁺group(13 cases) and MRD^- group(52 cases). We compared and analyzed the prognosis of CR group and NCR group, MRD⁺group and MRD^- group. And we explore the correlation between whether MRD turned negative before transplantation and the prognosis of patients.Results: There were significant differences in the 3-year overall survival rate(72.4% vs 0), disease-free survival rate(67.1% vs 0) and cumulative recurrence rate(36.1% vs 100%) between CR group and NCR group(P<0.001). In patients with CR, there were significant differences in the 3-year overall survival rate(41.5% vs 52.9%), disease-free survival rate(41.5% vs 55.8%) and cumulative recurrence rate(67.6% vs 33.6%) between MRD⁺group and MRD^- group(P<0.05).Conclusion: The detection of negative MRD before transplantation can be an important prognostic factor in the treatment of allogeneic hematopoietic stem cell transplantation in T-ALL patients.
- acute T-lymphoblastic leukemia /
- allogeneic hematopoietic stem cell transplantation /
- minimal residual disease

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