Study Of The Prognostic Significance Of Post-induction Minimal Residual Disease In Cclg-all2008Protocol In Chongqing, China

Objective To assess the prognostic significance of post-inductionminimal residual disease (MRD) of Chinese Children’ s Leukemia Groupprotocol in childhood acute lymphoblastic leukemia in Children’ s Hospitalof Chongqing Medical University.Methods206children with newly diagnosed ALL were treated withthe CCLG-ALL2008protocol.6patient were excluded in statisticalanalysis. In this protocol,200patients were divided into groups of standardrisk (SR), intermediate risk (IR) and high risk (HR), then treated withcorresponding drugs and dosage. At the same time, post-induction MRDwas detected as a prospective study. Survival analysis was done by usingSPSS for Windows.Results200childhood ALL patients were treated with the CCLG-ALL2008protocol, and post-induction MRD was detected by flow cytometrymethod (FCM) at day33. The overall Three years event-free survival (EFS)rate (±SE) was (78.40±4.60)%; EFS was (81.70±4.10)%in MRD＜10-4,(81.30±9.80)%in10-4≤MRD＜10-2,(44.40±16.60)%in MRD≥10-2. Post-induction MRD, T-ALL for immunophenotype and BCR/ABL fusiongene positive are independent prognostic risk factors.Conclusion The outcome of patients treated with the CCLG-2008Protocol was favorable. Patients with post-induction MRD≥10-2have muchlower Three years event-free survival (EFS) rate. Post-induction MRD is anindependent prognostic risk factor. The study reveal that if post-inductionMRD were considered in risk stratification, more patients in HR group canbe screened early, so as to receive intense chemotherapy early. Therefore, itis very important to detect post-induction MRD to make a objective andaccurate risk stratification in childhood acute lymphoblastic leukemia.