Blood:二代测序检测CLL一线化疗后的微小残留病灶的敏感性更高

2019-09-23 MedSci MedSci原创

在一线FCR后达到血液或骨髓(BM)无法检测到最小残留病灶(U-MRD,即MRD≤10-4,简称MRD4)状态的慢性淋巴细胞白血病(CLL)患者的无进展生存期(PFS)延长。但很多患者即使达到了U-MRD4,尤其是IGHV无突变的患者,随后都会复发,表明残留病灶<10-4阈值,我们需要更敏感的MRD评估方法。通过二代测序(NGS)评估MRD的敏感性可达到10-6(MRD6)。为了更好的评估一

在一线FCR后达到血液或骨髓(BM)无法检测到最小残留病灶(U-MRD,即MRD≤10-4,简称MRD4)状态的慢性淋巴细胞白血病(CLL)患者的无进展生存期(PFS)延长。但很多患者即使达到了U-MRD4,尤其是IGHV无突变的患者,随后都会复发,表明残留病灶<10-4阈值,我们需要更敏感的MRD评估方法。

通过二代测序(NGS)评估MRD的敏感性可达到10-6(MRD6)。为了更好的评估一线FCR治疗后的缓解深度,研究人员用NGS评估了62位患者的MRD,这62位患者,在FCR治疗后,经多色流式细胞检测全为BM U-MRD。共有57份BM样本、29份外周血单核细胞(PBMC)样本和32份血浆样本。

通过NGS,仅27.4%的患者为U-MRD。NGS检测的BM、PBMC和血浆的U-MRD率分别为25%、55%和75%。NGS检测的BM U-MRD或PBMC U-MRD的个体均为血浆U-MRD。与IGHV野生型的患者相比,携带IGHV突变的患者在治疗后更可能为U-MRD(NGS)。中位随访时间为81.6个月。U-MRD患者的无进展存活期(PFS)优于MRD+患者,无论样本类型。

综上所述,本研究表明MRD6检测比MRD4检测更敏感,预后预测价值更高。

原始出处:

Philip A Thompson, et al.Undetectable MRD Using Next Generation Sequencing is Associated With Improved PFS After Treatment with FCR for CLL.Blood 2019 :blood.2019001077; doi: https://doi.org/10.1182/blood.2019001077

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    2019-09-24 14723bb8m44暂无昵称

    不错的文章,学习了。

    0

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    2019-09-24 14723bb8m44暂无昵称

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