Abstract
BackgroundThis meta-analysis was performed to explore the impact of minimal residual disease (MRD) prior to transplantation on the prognosis for patients with acute lymphoblastic leukemia (ALL).MethodsA systematic search of PubMed, Embase, and the Cochrane Library was conducted for relevant studies from database inception to March 2016. A total of 21 studies were included.ResultsPatients with positive MRD prior to allogeneic stem cell transplantation (allo-SCT) had a significantly higher rate of relapse compared with those with negative MRD (HR = 3.26; P < 0.05). Pre-transplantation positive MRD was a significant negative predictor of relapse-free survival (RFS) (HR = 2.53; P < 0.05), event-free survival (EFS) (HR = 4.77; P < 0.05), and overall survival (OS) (HR = 1.98; P < 0.05). However, positive MRD prior to transplantation was not associated with a higher rate of nonrelapse mortality.ConclusionsPositive MRD before allo-SCT was a predictor of poor prognosis after transplantation in ALL.Trial registrationNot applicable.
Highlights
This meta-analysis was performed to explore the impact of minimal residual disease (MRD) prior to transplantation on the prognosis for patients with acute lymphoblastic leukemia (ALL)
Studies in PubMed, Embase, and the Cochrane Library were searched from the database inception to March 2016, using the following text and/or medical subject heading terms: (1) “acute lymphoblastic leukemia” or “acute lymphoblastic leukaemia”; (2) “minimal residual disease”; (3) “relapse” or “relapse-free survival” or “leukemia-free survival” or “leukaemia-free survival” or “disease-free survival” or mortality; and (4) transplantation
4 studies of autologous stem cell transplantation and 19 studies that did not present the association between pre-transplant MRD and outcomes were discarded
Summary
This meta-analysis was performed to explore the impact of minimal residual disease (MRD) prior to transplantation on the prognosis for patients with acute lymphoblastic leukemia (ALL). The relapse rate is approximately 15–20% in ALL, and the cure rate is much lower after relapse [3] These relapses are due to the persistence of residual malignant cells, namely minimal residual disease (MRD), that. A body of evidence indicated a direct correlation of the likelihood of relapse after transplant with the MRD status before transplantation [15, 16]. This significant association was not observed in some studies [17,18,19,20].
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