文章：

定义共识白血病相关免疫表型检测微小残留疾病的急性髓系白血病在多中心设置

Defining consensus leukemia-associated immunophenotypes for detection of minimal residual disease in acute myeloid leukemia in a multicenter setting

原文发布日期：2013-08-02

DOI: 10.1038/bcj.2013.27

类型: Original Article

开放获取: 是

英文摘要：

Flow-cytometric detection of minimal residual disease (MRD) has proven in several single-institute studies to have an independent prognostic impact. We studied whether this relatively complex approach could be performed in a multicenter clinical setting. Five centers developed common protocols to accurately define leukemia-associated (immuno)phenotypes (LAPs) at diagnosis required to establish MRD during/after treatment. List mode data files were exchanged, and LAPs were designed by each center. One center, with extensive MRD experience, served as the reference center and coordinator. In quarterly meetings, consensus LAPs were defined, with the performance of centers compared with these. In a learning (29 patients) and a test phase (35 patients), a mean of 2.2 aberrancies/patient was detected, and only 1/63 patients (1.6%) had no consensus LAP(s). For the four centers without (extensive) MRD experience, clear improvement could be shown: in the learning phase, 39–63% of all consensus LAPs were missed, resulting in a median 30% of patients (range 21–33%) for whom no consensus LAP was reported; in the test phase, 27–40% missed consensus LAPs, resulting in a median 16% (range 7–18%) of ‘missed’ patients. The quality of LAPs was extensively described. Immunophenotypic MRD assessment in its current setting needs extensive experience and should be limited to experienced centers.

摘要翻译： 

流式细胞术检测微小残留病（MRD）已在多项单中心研究中被证实具有独立的预后价值。本研究旨在探讨这种相对复杂的方法是否能在多中心临床环境中实施。五个中心共同制定了标准化方案，用于在诊断时精确定义白血病相关（免疫）表型（LAPs），以便在治疗期间/后建立MRD监测体系。各中心交换了列表模式数据文件并独立设计LAPs。其中一个具有丰富MRD经验的中心作为参考中心和协调者。在季度会议中，明确定义了共识性LAPs，并将各中心的检测性能与之对比。在学习阶段（29例患者）和测试阶段（35例患者）中，平均每位患者检测到2.2个异常表型，仅1/63例患者（1.6%）未形成共识性LAPs。四个缺乏（丰富）MRD经验的中心显示出明显进步：在学习阶段，39-63%的共识性LAPs被遗漏，导致中位30%的患者（范围21-33%）未报告共识性LAPs；在测试阶段，遗漏率降至27-40%，中位“遗漏”患者比例为16%（范围7-18）。研究详细描述了LAPs的质量标准。现行体系下的免疫表型MRD评估需要丰富经验，应限于经验丰富的中心开展。

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