To evaluate the prognostic value of pre-transplant measurable residual disease (MRD) detected by multiparameter flow cytometry (MFC) and high-risk (HR) fusion genes on survival after transplantation in pediatric AML patients.
Approach:
Study Design: A single-center retrospective study including 80 newly diagnosed pediatric AML patients who underwent allo-HSCT during their first complete remission.
Statistical Analysis: Cox regression models were employed for statistical analysis of survival outcomes.
Key Findings:
3-year disease-free survival (DFS) rate was 85.5% ± 4.2%.
3-year overall survival (OS) rate was 86.8% ± 4.1%.
Pre-transplant MFC-MRD positivity was confirmed as an independent adverse prognostic factor for both DFS (HR = 14.304, P = 0.010) and OS (HR = 15.847, P = 0.008).
Interpretation:
Pre-transplant MFC-MRD positivity is an independent adverse prognostic marker for survival in pediatric AML patients following allo-HSCT.
Limitations:
The study is based on a limited number of cases with specific HR fusion genes, requiring validation in larger cohorts.
Conclusion:
Achieving deep remission before transplantation is crucial to reduce tumor burden.
