Influence of pre-transplant minimal residual disease on prognosis after Allo-SCT for patients with acute lymphoblastic leukemia: systematic review and meta-analysis

BMC Cancer. 2018 Jul 23;18(1):755. doi: 10.1186/s12885-018-4670-5.

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.

Keywords: Acute lymphoblastic leukemia; Allogeneic stem cell transplantation; Minimal residual disease.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Child
  • Disease-Free Survival
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Neoplasm, Residual
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Prognosis
  • Publication Bias
  • Recurrence
  • Transplantation, Homologous