Study On The Correlation Between MRD Detection And AML Prognosis

Objective:MRD levels of patients with acute myeloid leukemia after complete remission of the first chemotherapy were measured by multiparameter flow cytometry to evaluate the remission of patients with acute myeloid leukemia after the first chemotherapy and to consolidate the relationship between MRD levels and disease recurrence and survival during treatment.To further explore the value of detecting minimal residual disease in the development of the course of acute myeloid leukemia,clinical efficacy evaluation,prognosis prediction.Methods:Taking the patients with acute myeloid leukemia(except M3)in hematology department of the first affiliated hospital of Shihezi University Medical College as the research object,79 patients with acute myeloid leukemia were treated in our hospital from January 2015 to January 2019.After M3 type and no chemotherapy in our hospital,40 patients were obtained,including 24 men,60% women,16 women,40%,mean age 56±17years old.the number of patients with complete remission after the first chemotherapy was27.retrospective methods were used to collect MRD levels after initial treatment in 40 patients included in the study,and to collect MRD levels and bone marrow cell morphological results during consolidation chemotherapy in remission patients until patient death or study termination.The patients were divided into four groups according to the MRD level of the patients who reached CR after induction treatment and the MRD level of the patients during consolidation treatment.Analysis of 40 patients after initial treatment and remission during consolidation induction of different levels of MRD and recurrence,genetic prognosis stratification,survival.MRD>10-4 was used as the MRD positive standard.Results:1.There was no significant correlation between age,sex,WBC level at first visit and FAB type in the general biological characteristics of patients(P>0.05);2.There was no significant difference between MRD positive group and MRD negative group after first chemotherapy(P>0.05);3.Patients with complete remission were MRD consistently positive for recurrence(P=0.029);4.The MRD negative rate of patients with good prognosis was higher than that of other prognostic groups(P=0.021).There was no significant correlation between MRD levels of patients with good prognosis(P>0.05);5.The risk of recurrence in the MRD negative group after initial treatment of 2.was 0.081 times higher than that in the MRD positive group,P=0.010<0.05.this difference was statistically significant,suggesting that the positive group had a high risk of recurrence after initial treatment.to obtain complete remission patients,compared with the MRD continuous negative group,the risk of recurrence in the MRD continuous positive group was 21.333 times higher than that in the continuous negative group,P=0.015<0.05.the difference was statistically significant,suggesting that the prognosis of patients who continued to turn negative after remission was better;6.The survival rate of MRD positive patients after first chemotherapy was much lower than that of MRD negative patients(P=0.006,the difference was statistically significant),and the survival rate of MRD positive patients after first treatment was also much lower than that of negative patients(0.012,the difference was statistically significant)Conclusion:1.The level of early and continuous detection of MRD has important clinical significance in judging the recurrence of AML patients,improving survival time and predicting prognosis;2.The level of detection MRD can be used as one of the bases for judging AML prognosis stratification.