Influence of pre-transplant minimal residual disease on prognosis after Allo-SCT for patients with acute lymphoblastic leukemia: systematic review and meta-analysis
Zhenglei Shen,
Xuezhong Gu,
Wenwen Mao,
Liefen Yin,
Ling Yang,
Zhe Zhang,
Kunmei Liu,
Lilan Wang,
Yunchao Huang
Affiliations
Zhenglei Shen
Department of Hematology, The Third Affiliated Hospital of Kunming Medical University
Xuezhong Gu
Department of Hematology, The First People Hospital in Yunnan Province
Wenwen Mao
Department of Geriatrics, The Second Hospital of Kunming
Liefen Yin
Department of Hematology, The Second Affiliated Hospital of Kunming Medical University
Ling Yang
Department of Hematology, The Second Affiliated Hospital of Kunming Medical University
Zhe Zhang
Department of Hematology, The Second Affiliated Hospital of Kunming Medical University
Kunmei Liu
Department of Hematology, The Third Affiliated Hospital of Kunming Medical University
Lilan Wang
Department of Chest Surgery, The Third Affiliated Hospital of Kunming Medical University
Yunchao Huang
Department of Chest Surgery, The Third Affiliated Hospital of Kunming Medical University
Abstract Background 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). Methods A 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. Results Patients 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. Conclusions Positive MRD before allo-SCT was a predictor of poor prognosis after transplantation in ALL. Trial registration Not applicable.
