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| Predictive Value of Dynamic Monitoring of Minimal Residual Disease Levels after Induction Chemotherapy for Short-Term Prognosis in Children with Acute Myeloid Leukemia |
| SUN Jia, LIU Junshan, XIE Xin |
| Zhengzhou University Children's Hospital / Henan Children's Hospital / Zhengzhou Children's Hospital / Henan Key Laboratory of Pediatric Hematology, Zhengzhou Henan 450018 |
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Abstract 【Objective】 To investigate the predictive value of dynamic monitoring of minimal residual disease (MRD) levels after induction chemotherapy for short-term prognosis in children with acute myeloid leukemia (AML).【Methods】 Ninety-six children with AML were enrolled and divided into a poor prognosis group (n=35) and a good prognosis group (n=61) according to disease progression within 12 months after completion of chemotherapy. Clinical parameters and MRD levels after the first and second courses of induction chemotherapy were compared between the two groups. The dynamic MRD evolution patterns and their predictive value for prognosis were analyzed based on MRD results.【Results】 There were no significant differences in age, sex, or French-American-British(FAB) classification between the two groups (P>0.05). Compared with the good prognosis group, the poor prognosis group had higher initial white blood cell (WBC) counts, higher Charlson Comorbidity Index (CCI) scores, a greater proportion of bone marrow blasts ≥50%, and a higher incidence of high-risk chromosome karyotypes, while platelet counts (PLT) were lower (P<0.05). The MRD-positive rates after the first and second induction chemotherapy cycles in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05). The distribution of dynamic MRD evolution patterns differed significantly between the two groups (P<0.05), with the persistent positive pattern predominating in the poor prognosis group. Receiver operating characteristic (ROC) curve analysis showed that MRD positivity after the first and second induction chemotherapy cycles, as well as dynamic MRD evolution patterns, could effectively predict relapse risk in children with AML. The dynamic MRD evolution demonstrated superior predictive performance (P<0.05).【Conclusion】 The dynamic evolution pattern of MRD provides better predictive value for relapse risk in children with AML than single-point MRD detection after the first or second induction chemotherapy, and can serve as an important reference indicator for prognosis assessment.
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Received: 21 May 2025
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2025, Vol. 42 
