| Objective To explore the clinical significance of recurrence judgment,prognosis assessment and individualized treatment by applying flow cytometry?FCM?to dynamically monitor the changing trends of minimal residual disease?MRD?in acute leukemia?AL?patients?non-M3?after induction treatment.Methods 76 adult?At least 14 years old?AL patients?non-M3?with detection of MRD were collected from October 2009 to June 20 16 in our hospital.All patients were diagnosed according to the international"MICM"criteria,and detected cytomorphology each time the detection of MRD.With a positive threshold of 1×10-4 for MRD,we respectively analyzed the recurrence rate and recurrence-free survival?RFS?time of patients with MRD positive and MRD negative in AML and ALL patients after the CR within 3 months,6 months,12 months and 12 months later.To analyze the relationgship between the dynamic changes of MRD and the recurrence,prognosis and treatment of AL patients.Results A total of 33 samples were detected in 57 AML patients?non-M3?after the CR within 3 months,in which 7 cases were MRD positive,and 6 cases were relapsed,while 26 cases were MRD negative,and 5 cases w ere relapsed,and there was significant difference between the two groups?P<0.05?;The median RFS of MRD positive and negative patients was 1 month?0-8 months?,13.5months?3-37 months?respectively,and the results were significantly different?P<0.05?.A total of 24 samples were detected after the CR within 6 months,and all of the 24 samples were MRD negative,in which 4 cases were relapsed;The median RFS was 29 months?3-36 months?.A total of 35 samples were detected after the CR within 12 months,in which 7 cases were MRD positive,and 2 cases were relapsed,while 30 cases were MRD negative,and 7 cases were relapsed,and there was no significant difference between the two groups?P=0.586?;The median RFS of MRD positive and negative patients was 5 months?4-10 months?,25 months?1-35 months?respectively,and the results were significantly different?P<0.05?.A total of 142 samples were detected after 12 months of the CR,in which 29 cases were MRD positive,and 12 cases were relapsed,while 113 cases were MRD negative,and 23 cases were relapsed,and there was significant difference between the two groups?P<0.05?;The median RFS of MRD positive and negative patients was 5 month?0-24 months?,25 months?1-35 months?respectively,and the results were significantly different?P<0.05?.A total of 9samples were detected in 19 ALL patients after the CR within 3 months,in which 4cases were MRD positive,and 3 cases were relapsed,while 5 cases were MRD negative,and 1 cases were relapsed,an d the results had no significant difference?P<0.05?;The median RFS of MRD positive and negative patients was 4.5 month?0-10 months?,8 months?5-16 months?respectively,and there was significant difference between the two groups?P<0.05?.A total of 9 samples were detected after the CR within 6 months,in which 4 cases were MRD positive,and 2 cases were relapsed,while 5 cases were MRD negative,and 1 cases were relapsed,and the results had no significant difference?P=0.524?;The median RFS of M RD positive and negative patients was 3 month?0-5 months?,24 months?3-27 months?respectively,and the results were significantly different?P<0.05?.A total of 11samples were detected after the CR within 12 months,in which 4 cases were MRD positive,and 3 cases were relapsed,while 7 cases were MRD negative,and no case was relapsed,and the results were significantly different?P<0.05?;The median RFS of MRD positive and negative patients was 1.5 month?0-3 months?,10months?3-25 months?respectively,and the results were significantly different?P<0.05?.A total of 29 samples were detected after 12 months of the CR,in which 6cases were MRD positive,and all of the 6 cases were relapsed,while 23 cases were MRD negative,and 3 cases were relaps ed,and there was significant difference between the two groups?P<0.05?;The median RFS of MRD positive and negative patients was 10 month?0-15 months?,14 months?1-24 months?respectively,and the results were significantly different?P<0.05?.Conclusion Flow cytometry for MRD detection can detect recurrence of AL patients earlier than cytomorphology;MRD level cannot serve as the sole indicator to evaluate the treatment effect of AL;The dynamic changes of MRD after the CR can predict the recurrenc e and prognosis of adult AL;MRD levels can provide a reliable basis for individual clinical treatment of adult AL. |
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