Measurable residual disease (MRD) detected by flow cytometry (FC) is well established in paediatric B- lymphoblastic leukaemia (B-ALL) and adult chronic lymphocytic leukaemia (CLL), but its utility in adult B-ALL and adult acute myeloid leukaemia (AML) is less clear. In this prospective MRD study, one of the largest in Australia to date, we examined consecutive bone marrow aspirates from adult participants with B-ALL (n= 47) and AML (n= 87) sent for FC-MRD testing at a quaternary referral hospital in Sydney. FC-MRD results were correlated to corresponding Mol-MRD testing where available and clinical outcomes at three-month intervals over 1 year. B-ALL showed a moderate positive correlation (rs= 0.401,p< 0.001), while there was no correlation between FC-MRD and Mol-MRD for AML (rs= 0.13,p= 0.237). Five FC-MRD patterns were identified which had significant associations with relapse (X2(4) = 31.17(4),p> 0.001) and survival (X2(4) = 13.67,p= 0.008) in AML, but not in B-ALL. The three-month MRD results were also strongly associated with survival in AML, while the association in B-ALL was less evident. There was a moderate correlation between FC-MRD and Mol-MRD in B-ALL but not AML. The association of FC-MRD with relapse and survival was stronger in AML than in B-ALL. Overall, these findings suggest divergent utilities of FC-MRD in AML and B-ALL.
流式细胞术检测的可测量残留病在儿童B淋巴细胞白血病和成人慢性淋巴细胞白血病中已得到充分证实，但其在成人B淋巴细胞白血病和成人急性髓系白血病中的应用价值尚不明确。在这项前瞻性可测量残留病研究中——迄今为止澳大利亚规模最大的研究之一，我们检测了悉尼一家四级转诊医院送检的成人B淋巴细胞白血病患者和急性髓系白血病患者的连续骨髓穿刺样本。流式细胞术可测量残留病检测结果与对应的分子学可测量残留病检测结果（若可获得）以及为期一年的每三个月临床结局进行相关性分析。B淋巴细胞白血病患者中观察到中度正相关性，而急性髓系白血病患者的流式细胞术与分子学可测量残留病检测结果无显著相关性。研究识别出五种流式细胞术可测量残留病动态模式，在急性髓系白血病中与复发和生存显著相关，但在B淋巴细胞白血病中未发现类似关联。三个月可测量残留病检测结果与急性髓系白血病患者的生存期密切相关，而在B淋巴细胞白血病患者中这种关联性较弱。流式细胞术与分子学可测量残留病检测在B淋巴细胞白血病中呈中度相关，在急性髓系白血病中则无相关性。流式细胞术可测量残留病与复发及生存的关联性在急性髓系白血病中较B淋巴细胞白血病更为显著。总体而言，这些发现提示流式细胞术可测量残留病检测在急性髓系白血病和B淋巴细胞白血病中具有不同的应用价值。
肿瘤(癌症)患者之家