Prognostic significance of MRD and its correlation with arsenic concentration in pediatric acute promyelocytic leukemia: a retrospective study by SCCLG-APL group

作者：Zhong Fan, Liangchun Yang, Liang-Chun Yang, Yi-Qiao Chen, Wuqing Wan, Dun‐hua Zhou, Hui-Rong Mai, Wan-Li Li, Li-Hua Yang, Lihua Yang, He-Kui Lan, Zijun Zhen, Bi-Yun Guo, Guohua Chen, Riyang Liu, Guo-Hua Chen, Xiao-Qin Feng, Cong Liang, Li-Na Wang, Yu-Li, Xue-Qun Luo, Danping Huang, Xue-Qun Luo, Bin Li, Li-Bin Huang, X. Zhang, Yan‐Lai Tang · 发表于：Therapeutic Advances in Hematology · 年份：2025 · DOI：10.1177/20406207241311774 · 被引用次数：7 · 研究领域：Retinoids in leukemia and cellular processes、Arsenic contamination and mitigation、Drug-Induced Ocular Toxicity

Background: Treatment outcomes for acute promyelocytic leukemia (APL) have improved with all-trans-retinoic acid and arsenic trioxide, yet relapse remains a concern, especially in pediatric patients. The prognostic value of minimal residual disease (MRD) post-induction and the impact of arsenic levels during induction on MRD are not fully understood. Objectives: To evaluate the relationship between post-induction MRD levels and relapse-free survival (RFS) in pediatric APL patients, and to investigate the correlation between blood arsenic concentration levels during induction therapy and MRD status. Design: A retrospective analysis of pediatric APL patients enrolled in a clinical trial from September 2011 to July 2020. Methods: We assessed the relationship between RFS and post-induction MRD levels using the log-rank test. The optimal MRD cut-off was determined using the “surv_cutpoint” function in the survminer R package. Arsenic concentration levels were monitored in 16 patients on days 7 and 14 of induction therapy, and Spearman correlation was used to analyze the relationship between arsenic concentrations and MRD levels. Results: Among 176 pediatric APL patients, with a median follow-up of 6 years, 4 relapsed. Patients with MRD >3.1% had significantly lower RFS compared to those with MRD ⩽3.1% (94.6% vs 100%, p = 0.023). In addition, a negative correlation was found between blood arsenic concentration levels and post-induction MRD levels. Lower arsenic concentrations we...