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Previous data show that about 40% of children with acute lymphoblastic leukemia (ALL) are cured with restrictive anti-metabolic drug-based chemotherapy.
, however, it is still not possible to accurately identify patients with very low risk (VLR).
patients selected based on the symptoms of induction therapy on the 19th day and the level of minimum residual disease (MRD) - lt;0.01% can obtain a better prognosis after low-intensity treatment.
in this study, Sidhom and others investigated the effects of MRD levels between 0.001% and 0.01% on prognostication in VLR ALL patients treated with low-intensity programs.
from October 2011 to September 2015, a total of 200 patients with B-precipice ALL had good clinical pathological characteristics and received low-intensity treatment at MRD-lt;01% on and after the 19th day and end of induction therapy.
five-year event-free survival rate was 89.5% (±2.2% SE) and the total survival rate was 95.5% (±1.5% SE).
5-year cumulative recurrence rate (CIR) was 7% (95% CI, 4% to 11%).
MRD levels detected on the 19th day in 29 patients were between 0.001% and 0.01%.
the five-year CIR values of these patients were significantly higher than those of patients with unretested residual lesions (17.2% ±7.2% vs 5.3% ±1.7%, P -0.02).
, the study showed that children with VLR ALL could recover with low-intensity therapy, suggesting that the classification criteria for VLR could be further improved with more sensitive MRD testing.
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